If you are a Rhode Island Medicaid provider who hasn’t completed screening and enrollment with the state Medicaid program, please do so prior to Feb. 1, 2024 to ensure that you can continue to participate in our Tufts Health RITogether network.
The 21st Century Cures Act requires that states screen and enroll all providers rendering services to Medicaid members, regardless of specialty. Information on this requirement has been mailed to Rhode Island Medicaid providers and was included in previous issues of our provider newsletter.
Rhode Island Medicaid providers should be aware of the following deadlines established by the Rhode Island Executive Office of Health and Human Services (EOHHS):
- Tufts Health Plan must deny claims for Rhode Island Medicaid providers who are not enrolled with the state’s Medicaid program for claims with dates of service on or after Nov. 1, 2023.
- If Rhode Island Medicaid providers do not complete screening and enrollment with the state’s Medicaid program before Feb. 1, 2024, they will no longer be eligible to provide services to our Medicaid-eligible members, and Tufts Health Plan will be required to terminate you from the Tufts Health Public Plans network.
Your participation in our other lines of business may be affected, subject to Rhode Island regulations.
How to complete your screening and enrollment
We encourage unscreened providers to complete screening and enrollment with Rhode Island Medicaid as soon as possible — to allow you to receive reimbursement for Tufts Health RITogether members and to ensure you can remain in our Tufts Health Public Plans network in the future.
The application for enrollment/screening can be accessed directly on the RI Medicaid Healthcare Portal (www.riproviderportal.org). You’ll also find a Provider Enrollment User Guide there, and additional information can be found on the RI EOHHS website (https://eohhs.ri.gov/providers-partners/provider-enrollment). If you have any other questions or concerns that are not answered by the Provider Enrollment User Guide, please contact the RI Medicaid Customer Service Help Desk at 800-964-6211.
Audrey Kleinberg,
Director, Provider Relations & Communications
Annmarie Dadoly,
Senior Manager, Provider Communications
Joseph O’Riordan, Susan Panos, Ryan Francis, Stephen Wong,
Writers
Kristin Edmonston,
Production Coordinator
Kristina Cicelova,
Graphic Designer