Rhode Island Code of Regulations
Title 210 - Executive Office of Health and Human Services
Chapter 30 - Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 05 - Service Delivery Options
Part 2 - Medicaid Managed Care Delivery Options
Section 210-RICR-30-05-2.54 - Pharmacy Home Program
Current through March 25, 2025
A. The objective of the Pharmacy Home Program is to prevent members from obtaining excessive quantities of prescribed medications through visits to multiple prescribers and pharmacies and improving health outcomes. Participants enrolled in the program are required to obtain all medications from a specific pharmacy location otherwise known as a "Pharmacy Home" for a period of two (2) years.
B. The EOHHS, or its contracted MCO, will establish criteria to identify members for inclusion in the Pharmacy Home Program. Members will be notified at least thirty (30) days prior to enrollment in the program.
C. Select provider referrals are available as part of the Pharmacy Home Program. The EOHHS, or its contracted MCO, will ensure that members with complex medical and/or behavioral health needs are connected with high quality select providers to meet those needs. Members who use multiple providers and have one or more complex medical conditions and chronic diseases shall be referred as needed to a select provider.
