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Provider Alerts - Provider Resources - 2024
Lymphedema Compression Treatment Items Now Covered by Medicare

A new benefit category has been established for Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for standard and custom-fitted compression garments and additional lymphedema compression treatment items that are primarily and customarily used to serve a medical purpose.

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Medicare
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Healthfirst CompleteCare and Senior Health Partners Changes to Non-Emergency Transportation Benefits

Healthfirst CompleteCare (HMO D-SNP) and Senior Health Partners (SHP) Changes to Non-Emergency Transportation Benefits, Effective March 1, 2024. Services now available through NYS Medical Answering Services (MAS).

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Healthfirst Plans
  
Provider Alerts - Practice Guidelines and Tips - 2024
Tips to Increase Colorectal Screenings

Remind patients to schedule a colorectal cancer exam starting at age 45. A screening can detect cancer early, when it’s easier to treat. Review these tips.

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Preventative Measures
  
Provider Alerts - Telehealth - Policy, Billing, or Coverage Update - 2021
Privileging of Providers to Offer Telehealth Services

Healthfirst has established a policy and application process to enable our network of contracted providers to offer telehealth services to our members to improve access to care and outcomes of care. The policy and application process detailed herein is applicable to all providers and vendors who wish to render telehealth services.

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Administration
  
Provider Alerts - Practice Guidelines and Tips - 2024
2024 Medicare CAHPS Season Starts in March

Between March and June, a random sample of Healthfirst Medicare Plan members will receive the annual Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey. The CAHPS survey measures member experience with their health plan and providers, including experience with accessing care and care coordination. For participating providers, ensuring your patients’ satisfaction will help improve your performance in the Healthfirst Quality Incentive Program (HQIP).

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Medicare
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Expanded Spinal Muscular Atrophy (SMA) Carrier Screening

New York State (NYS) Medicaid has provided coverage for Spinal Muscular Atrophy (SMA) carrier screening since 2014. However, effective October 1, 2023, the coverage criteria for SMA carrier screening has been expanded to all NYS Medicaid members who are planning to become, or already are pregnant.

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Preventative Measures
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
Mobile Crisis and Crisis Residence Services: Important Updates and FAQs

New York State received federal approval to consolidate and align its Mobile Crisis and Crisis Residence services effective March 1, 2024.

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Preventative Measures
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Mobile Crisis and Crisis Residence Service Changes

To improve access to crisis care, New York State received federal approval to consolidate and align its Mobile Crisis and Crisis Residence services. These Crisis Intervention State Plan Amendment (SPA) changes will start March 1, 2024.

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Preventative Measures
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
New York State Medicaid Guidance for Billing Respiratory Syncytial Virus (RSV) Vaccines

As of Oct. 1, 2023, New York State (NYS) Medicaid began reimbursing NYS Medicaid-enrolled providers for administration or dispensing of Respiratory Syncytial Virus (RSV) vaccines for adults and for the administration of nirsevimab for infants.

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Billing
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Cultural Competency Training for Participating Providers

New York State Department of Health requires providers and their office staff who have regular and substantial contact with Healthfirst members certify annually the completion of Cultural Competency Training.

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Behavioral Health
  
Provider Alerts - Compliance, Regulatory & Policies - Practice Guidelines and Tips - 2024
New State Requirements for Provider Compliance Programs

New York State has made changes to provider requirements for starting and maintaining compliance programs.

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Quality and Compliance
  
Provider Alerts - Provider Resources - 2022
Healthfirst Connection Plan (HMO D-SNP) Announcement

Starting Jan. 1, 2024, Healthfirst will begin covering members in Healthfirst Connection Plan (HMO D-SNP), our newest Medicare Advantage Dual-Eligible Special Needs Plan. Read the Provider Alert for more details...

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Connection Plan