MedicaidAdministrativeHigh impact
Rhode Island Medicaid enrollment/screening
Harvard Pilgrim Health Care·RI·Provider Newsletter
We identified it
Jul 6, 2026
Summary
Rhode Island Medicaid providers must complete state screening and enrollment through the RI Medicaid Healthcare Portal to maintain network participation with Tufts Health RITogether. The 21st Century Cures Act mandates this requirement for all providers treating Medicaid members regardless of specialty. Providers who fail to complete enrollment risk removal from the Medicaid network and loss of reimbursement.
Action Required
IMMEDIATELY: All Rhode Island Medicaid providers must verify their enrollment and screening status with the state Medicaid program. Billing team should: (1) Confirm each provider has completed RI Medicaid screening and enrollment via the RI Medicaid Healthcare Portal (https://dem.ri.gov/); (2) Document enrollment status for each provider in credentialing files; (3) Track application status using the portal; (4) Contact RI Medicaid Customer Service Help Desk at 800-964-6211 for any providers with incomplete applications. Consequences of inaction: Providers not screened and enrolled will be removed from the Tufts Health RITogether network, rendering them unable to bill for or treat Medicaid members, resulting in lost revenue and interrupted patient care.