Fully Integrated Dual Eligible Special Needs Plan Program (FIDE-SNP)

The Rhode Island Executive Office of Health and Human Services is soliciting proposals under solicitation number QLV27007040 to establish a Qualified List of Vendors for Managed Care Organizations to administer the Fully Integrated Dual Eligible Special Needs Plan Program. This program is designed to provide integrated Medicare and Medicaid benefits for full-benefit dually eligible individuals, covering primary, acute, behavioral health, durable medical equipment, and long-term services and supports. The contract is governed by the State Medicaid Agency Contract and the FIDE-SNP Manual, with a target effective date of January 1, 2028. Selected vendors must pass an operational readiness-testing program approximately ninety days before the operational start date and adhere to strict NCQA standards and CMS Medicare requirements. The award process involves a multi-phase evaluation including pass/fail minimum qualifications and business proposal requirements. Technical proposals are scored out of 100 points across seven factors, including organizational experience, population health, and network provider access, with a minimum score of 60 required to advance to the final evaluation phase where bonus points for ISBE participation may be awarded. Bidders must submit a searchable PDF proposal by November 4, 2026, adhering to strict page limits and formatting guidelines. Compliance requirements are extensive, encompassing HIPAA privacy and security rules, federal non-discrimination laws, cybersecurity training, and rigorous fiscal assurances.