Cell and Gene Therapy Access Model
The Cell and Gene Therapy (CGT) Access Model aims to improve the lives of people living with rare and severe diseases by increasing access to potentially transformative treatments. In July 2025, the Centers for Medicare & Medicaid Services (CMS) announced that Rhode Island and 32 other states will be participating in the model, and that Rhode Island is one of only seven states also receiving CGT Access Model Cooperative Agreement Funding. The initial focus of the model is on access to gene therapy treatments for people living with sickle cell disease, a genetic blood disorder.
Cell and gene therapies can transform the lives of people living with rare and severe diseases that are hard to treat, but gaining access to these potentially life-changing treatments is difficult because they can cost millions of dollars. The CGT Access Model supports outcomes-based agreements between states and manufacturers that will provide treatments within a framework that lowers prices for states and ties payment to outcomes.
What is Sickle Cell Disease?
Sickle cell disease (SCD) is a group of inherited red blood cell disorders. There are several types of SCD. People with SCD inherit genes that contain instructions, or code, for abnormal hemoglobin. Click here to learn more from the Centers for Disease Control and Prevention.
Resources for Providers and Managed-Care Organizations
The RI EOHHS Fee-for-Service Pharmacy Prior Authorization Program web page includes the Prior Authorization form
and clinical criteria for treatments. The links for each individual document are provided below as well.
Managed-Care Organization Clinical Policies
Boston Children’s Hospital
300 Longwood Avenue
Boston MA 02115
617-919-1992
Gene.therapy@childrens.harvard.edu
Approved for Casgevy and Lyfgenia
*Enrolled Medicaid Fee-for-Service provider
Boston Medical Center
One Boston Medical Center Place
Boston MA 02118
617-638-8130
Approved for Casgevy and Lyfgenia
Dana-Farber Brigham Cancer Center
450 Brookline Ave
Boston MA 02215
877-442-3324
Approved for Casgevy
Massachusetts General Hospital
55 Fruit St
Boston MA 02114
617-643-9042
Approved for Casgevy
Yale New Haven Hospital
20 York Street
New Haven CT 06510
Approved for Casgevy and Lyfgenia
To find additional qualified treatment centers, please go to: