Provider Screening Requirement for Compliance with 21st Century Cures Act

April 2022

The 21st Century Cures Act (Cures Act) 114 P.L. 255 requires all States to screen and enroll all Medicaid providers, both those in Medicaid fee-for-service (FFS) and managed care organizations (MCOs).

The RI Executive Office of Health and Human Services (EOHHS) is working with all MCOs to ensure all providers treating MCO members are enrolled with RI Medicaid.  Medicaid managed care network providers, regardless of specialty, are required to be screened by and enrolled with the State of RI Medicaid program. Providers who do not comply with this requirement risk being removed from the Rhode Island Medicaid program, FFS, and MCOs.

  • The State is identifying non-compliant providers in “waves” for Neighborhood/all MCOs to notify. The first wave of letters were mailed February 28, 2022.
  • Recipients have sixty (60) days from the date of notification to become compliant with the requirement.
  • Providers must follow the guidance in the notification to enroll in RI Medicaid through the EOHHS web portal at RIProviderPortal.org.
  • A “Provider Enrollment User Guide” is available on the RIProviderPortal.org website.
  • Providers can contact the EOHHS Customer Service Help Desk with questions:

If you receive communication to enroll with RI Medicaid from multiple managed care plans, you only need to submit one application.

*EOHHS has partnered with a vendor, Gainwell Technologies, to help with this project.

 

Last updated: June 8, 2023 @ 11:22 am