210 R.I. Code R. 210-RICR-30-05-2.27

Current through December 3, 2024

Section 210-RICR-30-05-2.27 - Services that are Not Covered by Medicaid

A. Non-covered services - The following services are not covered under the Medicaid program:

1. Experimental procedures, except as required by Rhode Island State law;

2. Private rooms in hospitals (unless medically necessary);

3. Cosmetic surgery;

4. Medications that treat erectile dysfunction or other sexual disorders;

5. Infertility treatment services; and

6. Any portion of services that exceeds fifteen (15) days provided in an Institution for Mental Diseases (IMD) for individuals between the ages of twenty-one (21) to sixty-four (64). RHP managed care enrollees may access IMDs.

B. Out-of-State Coverage - EOHHS does not routinely provide coverage for out-of State services with certain exceptions: Medicaid services provided in border communities are covered and emergency services are covered, within limits, at the discretion of EOHHS or the managed care organization.

210 R.I. Code R. 210-RICR-30-05-2.27

Amended effective 10/5/2021
Amended effective 12/12/2023
Amended effective 3/17/2024