Physician/ Medical Services
Provider Representative:
Karen Murphy (571) 348-5933
email: karen.murphy3@gainwelltechnologies.com
Program Information
- Anesthesia
- Nurse Practitioner
- OBGYN
- Pathology
- Physician
- Physician Assistant
- Radiology
- Radiology Prior Authorization Program
Provider Representative:
Andrea Rohrer (469) 897-4389
email: andrea.rohrer@gainwelltechnologies.com
Program Information
- Chiropractor
- Certified Nurse Anesthetist
- Podiatry
Provider Representative:
Marlene Lamoureux (571) 895-4938
email: marlene.lamoureux@gainwelltechnologies.com
Program Information
- Audiologist
Reference Guides
Updates
- Pursuant to the Rhode Island State Fiscal Year 2027 Enacted Budget, beginning October 1, 2026,Rhode Island Medicaid will no longer cover certain GLP-1 receptor agonists when they are prescribed solely for weight loss. Members receiving these medications for weight loss may be affected by this coverage change and may no longer be able to obtain them through Medicaid beginning October 1, 2026. For more information please see, GLP-1 State Budget Guidance.
- Office Visit Policy Limitations February 2025
- Pediatric Physician Rate Increase
- Billing Administration Codes for Vaccinations
- Prior Authorization for Durable Medical Equipment (DME)
- Equality in Abortion Coverage Act