CommercialAdministrativeMedium impact
Access to care standards for all providers
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Pediatrics +1 more·Provider Update
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI updated access to care standards defining who qualifies as primary care providers (PCPs), including MDs, DOs, nurse practitioners, physician assistants, and some Ob/Gyns. The policy establishes monitoring standards for member access to PCPs, behavioral health providers, and specialists.
Action Required
Immediately: Review current provider credentialing and ensure all PCPs meet the updated qualifications (board-certified MDs/DOs in internal medicine, pediatrics, or family medicine, or appropriately licensed nurse practitioners, physician assistants, and qualifying Ob/Gyns). Verify compliance with access to care monitoring standards for scheduling and member accessibility.