HF Logo HF Logo
Provider Home / Provider Alerts
Resource Type
Clear All
Filter
Year
Sort By
Showing 73-84 of 123
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2022
0996 22 Auth for Vision Svcs Provider Alert v7 FINAL

Effective August 1, 2022, Healthfirst no longer requires authorization for the selected vision services listed in this Provider Alert.

Open document
Authorization
  
Provider Alerts - Patient Care Resources - Practice Guidelines and Tips - 2022
Continuous Glucose Monitors for Diabetes Management

Healthfirst aims to enhance A1c control management, improve treatment outcomes, and prevent disease progression. We achieve these goals by first identifying Healthfirst plan members with Type 2 diabetes who are potentially eligible for a Continuous Glucose Monitor (CGM), after which we coordinate their care with providers to prevent future complications.

Open document
HF Cares
  
Provider Alerts - Claims & Billing - Pharmacy Resources & Formularies - Provider Resources - 2023
New Physician Dispenser Policy

After September 1, 2022, Medicaid pharmacy claims submitted from a physician dispenser will be rejected by Healthfirst’s pharmacy benefit manager, CVS Caremark

Open document
Billing
  
Provider Alerts - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2022
2022 Seasonal Influenza Vaccine Codes

These CPT influenza vaccine codes reflect updates to the recommendations on the use of seasonal influenza vaccines in the United States from the Advisory Committee on Immunization Practices (ACIP).

Open document
Vaccine Codes
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2022
Changes to Authorization Guidelines for Selected Services

Effective November 1, 2022, Healthfirst will make changes to its authorization guidelines for selected services. The service codes that newly require a prior authorization include pathology and laboratory services and non-oral and injectable chemotherapy drugs.

Open document
Prior Authorization
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Expansion of Lactation Service Coverage

Consistent with new requirements established for NYS Medicaid Managed Care (MMC) plans (including mainstream MMC plans, Human Immunodeficiency Virus (HIV) Special Needs Plans (HIV-SNPs), and Health and Recovery Plans (HARPs)), Healthfirst has expanded lactation services coverage under those plans to include reimbursement eligibility for providers certified by nationally recognized accrediting agencies.

Open document
Medicaid Managed Care
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2022
1448 22 BH PROS Auth Changes Provider Alert v2 Final WR

Effective Nov. 21, 2022, Healthfirst, in accordance with the State of New York, will no longer require prior authorization for Personalized Recovery Oriented Services (PROS).

Open document
Medicaid Managed Care
  
Provider Alerts - Behavioral Health and Foster Care - Policy, Billing, or Coverage Update - 2022
Behavioral Health Benefits Carve-In to Medicaid Advantage Plus (MAP)

Effective January 1, 2023, New York State (NYS) is carving additional Behavioral Health (BH) services into the Medicaid Advantage Plus (MAP) plan. Healthfirst's MAP plan is called CompleteCare.

Open document
Behavioral Health
  
Provider Alerts - Patient Care Resources - Policy, Billing, or Coverage Update - 2022
1560 22 Provider Alert Monkeypox Vaccine Coverage v5 FINAL wr

Healthfirst began covering the administration of the monkeypox vaccine on July 26, 2022. Learn more about two no-cost vaccines provided by The Centers for Disease Control and Prevention (CDC) and licensed by the U.S. Food and Drug Administration (FDA).

Open document
Monkeypox
  
Provider Alerts - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
New Reimbursement Policies for Laboratory Services

Effective June 1, 2023, Healthfirst is updating reimbursement policies for laboratory service providers with respect to our new partnership with Avalon.

Open document
Policy Reminder
  
Provider Alerts - Claims & Billing - Pharmacy Resources & Formularies - Plans & Benefits - Policy, Billing, or Coverage Update - 2023
Transition of the Pharmacy Benefit from Managed Care to Fee-for-Service

Effective April 1, 2023, Medicaid members enrolled in Medicaid Managed Care (MMC) Plans, Health and Recovery Plans (HARPs), and HIV-Special Needs Plans (SNPs) will receive their pharmacy benefits through the NYRx Pharmacy program, formerly known as the NYS Fee-for-Service (FFS) Pharmacy program.

Open document
Pharmacy
  
Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2023
Coverage Update: Monoclonal Antibody Therapies

As of December 1, 2022, bebtelovimab is not FDA-approved and will not be covered by Healthfirst. View details.

Open document
COVID-19
  
You are now navigating away from the Healthfirst website.

Links to non-Healthfirst websites are provided for your convenience only. Healthfirst is not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.