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and clinical criteria that do not apply to applicants seeking coverage through other Medicaid eligibility pathways. 3. Integrated Care -- The State’s Integrated Care Initiative (ICI) provides IHCC group members who have Medicare and other forms of third-party coverage who qualify for LTSS to obtain the coordinated services they need across the care continuum through a single plan. Subchapter 10 Part 1 of this Chapter covers these options and the process for managed care plan selection and enrollment. 4. Retroactive Eligibility – Up to three (3) months of Medicaid retroactive coverage is available for certain IHCC group beneficiaries. To qualify, the State must determine that a person would have met the applicable eligibility criteria for their coverage group if the application was submitted during the retroactive period. The State provides reimbursement to providers only for Medicaid covered services, however. The provisions in Subchapter 05 Part 3 of this Chapter explain the process for obtaining retroactive coverage in greater detail. 1.9 Service Delivery Options A. The service delivery options for IHCC group members are dictated in large part by type of Medicaid health coverage and eligibility pathway. B.

Overview IHCC Group Service Delivery Eligibility Pathway Service Delivery Option SSI, EAD with no Medicare Rhody Health Partners SSI, EAD with Medicare Rhody Health Options, PACE, Fee-for- Service (FFS) w/Community Health Team, or FFS-only LTSS No Medicare Same as above LTSS with Medicare Rhody Health Options, Medicare- Medicaid Plan II, PACE Sherlock/Ticket to Work Plan FFS