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Provider Alerts - Policy, Billing, or Coverage Update - 2023
Change in Level of Service Determinations and Prior Authorizations for Assertive Community Treatment

Effective June 20, 2023, Healthfirst, in accordance with the State of New York, will no longer require Level of Service Determinations (LOSD) or prior authorization for Assertive Community Treatment (ACT)

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ACT
  
Provider Alerts - Policy, Billing, or Coverage Update - 2023
Provider Alert: Prohibiting Copays at OTP Facilities (1205 23)

Effective Jan. 1, 2023, New York law (S.5690/A.372) prohibits commercial health insurance plans from imposing copayments and coinsurance for treatment delivered at an Opioid Treatment Program (OTP). This impacts Qualified Health Plan (QHP), commercial, and Essential Plan products

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QHP
  
Provider Alerts - Practice Guidelines and Tips - 2023
The Importance of Recertifications to Your Patients

New York State requires annual eligibility reviews and renewals for members enrolled in the following health insurance plans: - Medicaid - Essential Plan - Child Health Plus - Personal Wellness Plan (HARP) - Medicare Advantage plans with Medicaid or Medicare Savings Program - Managed Long-Term Care

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Recertification
  
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