NHPRINeighborhood Health Plan of Rhode Island (Medicaid)
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Prior to certification of NHPRI, the CHCs received cost-based reimbursement for their Medicaid clients, and they asserted that they could not continue to provide their full range of services under a Medicaid capitated payment system.
Clearly, the State could not allow clients to enroll in a non-licensed HMO; however, they did not want to exclude the NHPRI from participating at the start of the program.
Rhode Island's article has focused on the major implementation and operation issues that Rite Care has faced throughout its development and early months of operation to include the licensure of NHPRI.