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 July 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 allUpdated Healthfirst Policy for the Authorization of Applied Behavioral Analysis (ABA) Services
The updated ABA policy outlines applicable requirements, including coverage criteria, authorization requirements, documentation expectations, and other relevant guidance for ABA services.
View postPhysical and Occupational Therapy Authorization and Approval Guidance
To ensure Healthfirst members receive quality, consistent, and timely care, a provider questionnaire has been introduced to accompany the initial prior authorization request for Adult Physical Therapy.
View postDocumentation & Coding Refresh for July 2026
Take a mid-year moment to refresh your documentation and coding knowledge.
View postHealthfirst Lab Reimbursement Policy Updates
Please review these lab policies to understand how they may impact claims submission and payment.
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