Section 210-RICR-20-00-3.4 - Exceptions to the Requirement for Prior AuthorizationA. The following provisions are exceptions to the requirement for prior authorization: 1. Emergency medical treatment and hospital services needed because the beneficiary's health would be endangered if travel back to Rhode Island was required;2. Treatment was provided by hospitals and practitioners located in one (1) of the border communities listed in § 3.6 of this Part where it is the general practice for residents to use medical resources in these communities;3. Medical and hospital treatment provided to foster children residing with families located outside Rhode Island or in out-of-State residential treatment centers.4. In response to the novel Coronavirus Disease (COVID-19), EOHHS will temporarily suspend most of the prior authorization requirements. Effective October 1, 2021, prior authorization requirements will be reinstated for all services except for behavioral healthcare services. Effective January 1, 2022, prior authorizations will be reinstated for behavioral healthcare services.210 R.I. Code R. 210-RICR-20-00-3.4
Amended effective 10/5/2021