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Provider Alerts (Policy, Billing, or Coverage Update) - 2021
Removal of Service Limits: Physical Therapy, Occupational Therapy, and Speech Therapy

Starting January 1, 2021, Healthfirst will remove service limits on physical therapy (PT), occupational therapy (OT), and speech therapy (ST). Please note Healthfirst still requires prior authorization and will cover medically necessary PT, OT, and ST visits that are ordered by a doctor or other licensed professional.
Medicaid Managed Care
  
Benefits
  
  
Removal of Service Limits: Physical Therapy, Occupational Therapy, and Speech Therapy
Provider Alerts (Practice Guidelines and Tips) - 2021
Healthfirst Utilization Management

On December 23, 2020, the New York Department of Financial Services (DFS) issued Insurance Circular Letter No. 17, Coronavirus and the Suspension of Certain Utilization Review and Notification Requirements under the “Surge and Flex” Protocol. Access this document to learn about what Healthfirst is doing in response to this protocol and for more information.
Utilization Review
  
Skilled Nursing Facility
  
Behavioral Health
  
  
Healthfirst Utilization Management
Provider Alerts (Policy, Billing, or Coverage Update) - 2020
Medicare Monoclonal Antibody COVID-19 Infusion Program

On November 9, 2020, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the investigational monoclonal antibody therapy, bamlanivimab, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization.
COVID-19
  
Medicare
  
  
Medicare Monoclonal Antibody COVID-19 Infusion Program
Provider Alerts () - 2020
eviCore Healthfirst Provider Orientation Schedule (Nov 2020 to Jan 2021)

eviCore healthcare has been selected to provide utilization management services for the Healthfirst Lab Management Program. The program will begin accepting authorization requests on January 1, 2021 for dates of service on January 1, 2021 and later. eviCore healthcare will lead orientation sessions designed to assist you and your staff with the new utilization management programs. During these sessions we will discuss in detail the prior authorization requirements for each program and how to navigate the eviCore website at evicore.com.
Laboratory Services
  
  
1376 20 evicore Healthfirst Orientation Provider Alert v1 FINAL

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