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Provider Representative:  Ann Bennett  Tel.(401) 784-3840
Please Note: Consumers with questions regarding prescriptions please contact your case manager.

Program Information

Reference Guide



  • Covered Outpatient Drugs Rule Changes to Pharmacy Reimbursement
    As part of regulatory rules defined by the Covered Outpatient Drugs Rule, EOHHS is implementing changes to the reimbursement algorithm.  Medicaid Fee for Service (FFS) pharmacy claims reimbursement algorithm will include the CMS National Average Drug Cost (NADAC) price point and the pharmacy professional fee of $7.90 for recipients residing in a facility and $8.96 residing at home.  The EOHHS Drug Assistance Program claims will follow the FFS reimbursement algorithm.  These changes will take effect for claims with a date of service equal to or greater than, August 1, 2019.
  • Policy for the Treatment of Hepatitis C 
  • RI State Maximum Allowable Cost (MAC) List

Frequently Asked Questions (FAQ's)



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