Prior Authorization Annual Report
Rhode Island Medicaid is committed to making healthcare easier to navigate for members, providers, and partners. In January 2024, the Centers for Medicare & Medicaid Services (CMS) issued new national rules to strengthen the secure exchange of health information and improve the prior authorization process. These changes are designed to reduce delays, increase transparency, and ensure patients stay at the center of care.
As part of these requirements, state Medicaid programs must publicly share key prior authorization metrics each year. This report provides Rhode Island Medicaid’s annual prior authorization data, offering a clear look at how we review and process prior authorization requests.
