Essential Plan 200-250 Coverage to End July 1, 2026
How You Can Prepare and Support Your Patients
The New York State Essential Plan coverage for individuals with incomes between 200% and 250% of the Federal Poverty Level will end effective July 1, 2026.
Provider Updates for June 2026
Stay ahead of important changes that may impact your practice
Review updates to prior authorization, reimbursement policies, provider manual changes, and more—all in one place.
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What's New
View allHealthfirst’s Obstetric Billing Guidelines Reimbursement Policy
Healthfirst updated its Obstetric Billing Guidelines reimbursement policy to incorporate updated national coding standards and New York State (NYS) Medicaid billing guidance for maternity care.
View postPrior Authorization Required for Newly Released Codes Starting July 1, 2026
Codes newly released by the American Medical Association will include prior authorization requirements starting July 1, 2026.
View postPrior Authorization Required for Select Codes Starting October 1, 2026
Effective October 1, 2026, Healthfirst will require prior authorization for select medical services.
View postReimbursement Policies Updated in June 2026
Providers are encouraged to review these updated policies to ensure compliance with current billing and reimbursement requirements.
View postMedicare GLP-1 Bridge Program Begins July 1, 2026
The Medicare GLP-1 Bridge is a short-term demonstration run by CMS that will provide eligible Medicare Part D beneficiaries with access to certain GLP-1 drugs beginning July 1, 2026 through December 31, 2027.
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