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.
Pharmacy Medical Coverage Policies Pharmacy Coverage Policy Prescription Requirements Rebate Agreement Brand Necessary Prior Authorization Refillable Medication Maintenance Medication Pharmacy Billing Procedure Limitations Pertinent to Drugs and Pharmacy Services Drug Utilization Review (DUR) Program Prospective Drug Utilization Review (DUR) General Requirements Prospective DUR Screen Impact on Pharmacies Patient Counseling Impact on Pharmacies Patient Profiles (Medication Records) Impact on Pharmacies Pharmacy Lock-In Program Introduction Legal Basis Enrollment of Recipients Pharmacy Lock-In - REVS Responsibilities of the Primary Pharmacy of Choice Responsibilities of the Primary Care Physician Change in Primary Pharmacy/Physician and Recipient Status Pharmacy Pricing Policy Federal Upper Limits for Multiple Source Drugs DESI Drug List Over-the-Counter Product List Drug Manufacturers With OBRA 1990 Rebate Agreements Recipient Log Recipient Log Recipient Prescription Log Prescription Signature Log Certification Pharmacist's Daily Certification Error Status Codes ESC Code List (English) Explanation of Benefits (EOB) Codes EOB Codes and Messages List (English) EOB Codes and Messages List (Spanish) Appendix - Third Party Liability Carrier and Coverage Codes Third Party Liability Carrier and Coverage Codes For specific questions you may contact the Customer Service Help Desk at (401) 784-8100 for In-state and long distance callers, or 1-800-964-6211 for In-state toll callers and border communities.