Attention RI Medicaid Members: Update on Prescription Access Due to a cybersecurity issue, a contractor serving pharmacies and Medicaid programs across the US is unable to provide important online services at this time. In Rhode Island, this situation impacted pharmacies’ ability to fill prescriptions for members of the AIDS Drug Assistance Program (ADAP) and the Medicaid Program. In response, RI EOHHS has quickly brought online a new way for pharmacies to process claims. Rhode Island Medicaid has also told pharmacies that they can provide a 30-day supply of any prescriptions you are trying to fill, to help you get through this time. The pharmacy should not charge you for any prescription that is covered by Medicaid. Learn more.
Local Education Agency The Executive Office of Health and Human Services developed a Medicaid Direct Service Guidebook to assist Local Education Agencies (LEA) in Rhode Island with reimbursement for Medicaid services provided by or for a Local Education Agency. LEA's are responsible for maintaining records used to support claims submitted for Medicaid reimbursement. They also administer procedures to ensure program integrity. The content of the Guidebook includes: information on Medicaid provider enrollment, service definitions, provider qualifications, documentation guidelines, claim submittal information (including diagnosis and procedure codes), claim reconciliation information, eligibility verification, and other policies and regulations. LEA Administrative Claiming Guidebook, January 2020 LEA Direct Service Guidebook, September 2020 LEA Guidebook Addenda, September 2020 Vision Services Memo, 2020-10-16 LEA Guidebook Update Letter, 2019-12-17 2017 LEA Summary To speak with a Provider Representative about Medicaid reimbursement for LEA Services, please see Local Education Agency.