RIteSmiles 4-ALL Medicaid Managed Care Dental Services

The Rhode Island Executive Office of Health and Human Services is soliciting proposals from qualified Managed Care Organizations to administer the RIteSmiles 4-ALL Medicaid Managed Care Dental Program. The contract establishes a three-year base period from July 1, 2027, through June 30, 2030, with the possibility of three additional one-year renewals. The selected contractor will be responsible for comprehensive dental program functions, including the implementation of Initial Health Assessments for new members within 90 days of enrollment, integrated care coordination, case management, and the maintenance of a Quality Management/QI Committee. Performance is governed by NCQA standards, the RI Medicaid Dental Services Coverage Manual, and federal regulations including 42 CFR § 438.208(c)(3). The award process involves a multi-phase evaluation starting with a pass/fail screening of mandatory qualifications. Technical proposals are scored on a 1-4 scale across 185 items, requiring a minimum score of 85% to advance to the Impact Small Business Enterprise evaluation phase, where bidders can earn up to six additional points. Compliance requirements are extensive, encompassing HIPAA privacy and security rules, the Anti-Kickback Act of 1986, and various non-discrimination statutes such as Title VI of the Civil Rights Act and the Americans with Disabilities Act. Proposals must be submitted in four separate PDF files, with a combined page limit of 250 pages for the business and technical volumes.