State Overview: Rhode Island

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

In 2017, the four major insurers in Rhode Island signed an agreement with the health insurance commissioner to end the practice of prior authorization for MAT, including buprenorphine.

Rhode Island credentials two types of addiction counselors. An Advanced Chemical Dependency Professional (ACDP) I requires a high school diploma, 270 hours of relevant education courses and 300 hours of supervision. A post-secondary behavioral health degree may shorten the credentialing process. An ACDP II requires a master's degree, 180 hours of relevant education courses and 300 hours of supervision. R.I. Gen. Laws §5-69, Rhode Island Board of Licensing for Chemical Dependency Professionals and Rhode Island Board for the Certification of Chemical Dependency Professionals

Clinical counselors in mental health provide services to individuals, families or groups. These professional services include applying the principals, methods and theories of counseling and/or psychotherapeutic techniques to define goals and develop a treatment plan of action aimed toward the prevention, treatment and resolution of social, mental and emotional dysfunction and intrapersonal or interpersonal disorders in persons diagnosed at intake as nonpsychotic and not presenting medical problems. R.I. Gen. Laws. §5-63.2-2

The standards and requirements for certification of a peer recovery specialists are developed and administered by a third-party, non-profit certification provider.

Full independent practice and prescriptive authority.

The license to practice midwifery authorizes the holder to practice the independent management of cases of childbirth, including prenatal, intrapartum, postpartum, and normal newborn care, and well woman care including the management of common health problems that provides for consultation, collaborative management, or referral as indicated by the health status of the client in accordance with standards established by the American College of Nurse-Midwives and Midwives Alliance of North America.

A licensed nurse midwife is permitted to prescribe all legend medications and may apply for authorization to prescribe controlled substances Schedules II-V. 216-R. I. Code Regs. §40-05-23.9 ; 216-R.I. Code Regs. §40-05-23.10

Full independent practice and prescriptive authority.

The NP is licensed by the State Board of Nursing. R.I. Gen. Laws §5-34-3(2)

May prescribe legend drugs and Schedules II-V controlled substances if within the NP's role and population focus. R.I. Gen. Laws §5-34-49

NPs are authorized to sign medical Orders for life-sustaining treatment forms. R.I. Gen. Laws §23-4.11

NPs are recognized in state policy as primary care providers. An NP chooses a population focus of the patient population as a specialty. Population focus includes: family/Individual across the life span; adult-gerontology; neonatal; pediatrics; women's health/gender-related; and psychiatric/mental health. R.I. Gen. Laws §5-34-3(13)

Physician relationship required for practice and prescriptive authority.

The governing board of a licensed hospital, clinic or office, a licensed anesthetist, physician or dentist shall determine the scope of practice of CRNAs. All responsibilities shall be in writing in the form prescribed by hospital or office policy. Additionally, CRNAs shall practice in accordance with the current American Association of Nurse Anesthesiology guidelines for nurse anesthesia practice. R.I. Gen. Laws § 5-34.2-5

CRNAs may be granted prescriptive privileges in accordance with the provisions of R.I. Gen. Laws § 5-34.2 and R.I. Gen. Laws § 5-34-49(f).

Optometrists may only perform procedures related to foreign body removal and the examination, evaluation, diagnosis and treatment of the human eye. R.I. Gen. Laws §5-35.1-1(7)

Optometrists may not deliver any medication by injection. R.I. Gen. Laws §5-35.1-12(a)

Optometrists may prescribe Schedule III-V controlled substances and Schedule II controlled substances containing hydrocodone combinations. R.I. Gen. Laws §5-35.1-1(8)

A public health dental hygienist may perform services in a public health setting without the immediate supervision of a dentist. A written collaboration agreement is required between the hygienist and a local or state government agency or institution or a dentist. R.I. Gen. Laws §5-31.1-39

Statute does not identify dental therapists as an oral health provider.

Licensed providers using telemedicine in the practice of dentistry are subject to the same standard of care that would apply to the provision of the same dental care service or procedure in an in-person setting. R.I. Gen. Laws §27-8-3

Rhode Island has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Rhode Island does not allow pharmacists to modify prescriptions.

Rhode Island allows pharmacists to prescribe hormonal contraceptives.

A pharmacist may prescribe and dispense all short-term, FDA-approved hormonal contraceptives.

A pharmacist shall be required to:

1. Complete educational training approved by the state board of pharmacy that is related to prescribing hormonal contraceptives. This training shall include training on counseling on all methods of FDA-approved contraceptives, including those the pharmacist is not able to prescribe;
2. Provide a self-screening risk assessment tool, based on the current version of the U.S. Medical Eligibility Criteria for Contraceptive Use developed by the Federal Centers for Disease Control and Prevention, that the patient must complete prior to the pharmacist's prescribing the hormonal contraceptive;
3. Provide the patient with a written record of the hormonal contraceptive prescribed and dispensed and advise the patient to consult with a primary care practitioner or women's health care practitioner; and
4. Notify the patients primary care provider that the pharmacist prescribed and/or dispensed a short term, FDA-approved hormonal contraceptive. If the patient does not have a primary care provider, or refuses consent to notify the patients primary care provider, the pharmacist shall provide the patient a list of physicians, clinics or other health care providers to contact regarding follow-up care.
5. Dispense the contraceptives to the patient as soon as practicable after the pharmacist issues the prescription.

R.I. Gen. Laws §5-19.1-36

Rhode Island does not allow pharmacists to prescribe tobacco cessation aids.

Collaboration allowed with a physician for practice and prescriptive authority.

PAs shall practice in collaboration with physicians. A PA may provide any medical or surgical services that are within the PA's skills, education and training.

PAs may prescribe legend medications including Schedule II, III, IV and V medications, medical therapies, medical devices and medical diagnostics. R.I. Gen. Laws §5-54-8

Rhode Island does not currently have any provisions related to the number of PAs a physician can supervise or collaborate with

Rhode Island does not currently have any provisions related to chart review or co-chart signature.

Statute allows adaptable proximity.

"Collaboration" means the PA shall, as indicated by the patient's condition, the education, competencies, and experience of the physician PA, and the standards of care, consult with or refer to an appropriate physician or other healthcare professional. The degree of collaboration shall be determined by the practice and includes decisions made by a physician employer, physician group practice, and the credentialing and privileging systems of a licensed hospital, health center, or ambulatory care center. A physician must be accessible at all times for consultation by the PA. R.I. Gen. Laws §5-54-2(5)

A PA may perform health care services consistent with their expertise and that of the supervising physician. R.I. Gen. Laws §5-54-8