HF Logo HF Logo
Provider Home / Provider Alerts
Resource Type
Clear All
Filter
Year
Sort By
Showing 85-96 of 171
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 - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2023
Billing Guidance for COVID-19 Vaccine Under Healthfirst’s Plans

Healthfirst continues to monitor COVID-19 vaccine updates from the state and federal government and from other healthcare agencies. This guidance provides billing information on COVID-19 vaccines. (Updated June 2023)

Open document
Billing
  
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.

Open document
Preventive Measures
  
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 - 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).

Open document
Medicare
  
Provider Alerts - Pharmacy Resources & Formularies - Claims & Billing - 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
  
Provider Alerts - Policy, Billing, or Coverage Update - 2023
Inflation Reduction Act Impacts Cost Sharing for Medicare Part B Drugs

Beginning April 1, 2023, cost sharing for Medicare Part B Drugs will be impacted in accordance with §11101 and §11407 of the Inflation Reduction Act (IRA, P.L. 117-169)*

Open document
Quality and Compliance
  
Provider Alerts - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Provider Alert: Medicaid FFS Enrollment Requirement for Providers

Healthfirst has reinstated the Medicaid Management Information System (MMIS) enrollment requirement.

Open document
Medicaid
  
Provider Alerts - Plans & Benefits - Patient Resource - 2023
Provider Alert - 2023 FPL Expansion

Thanks to expanded eligibility, more Medicare beneficiaries will qualify for the Medicare Savings Program (MSP) in 2023.

Open document
Medicare
  
Provider Alerts - Plans & Benefits - Policy, Billing, or Coverage Update - 2023
Important: Recertifications are Resuming in 2023

New York State will resume eligibility reviews and renewals for members of with a recertification date after June 2023. If your patients do not renew on time, they risk losing health coverage and could face unexpected costs or even a gap in care. This Provider Alert contains instructions on how members can renew their coverage...

Open document
Recertification
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Authorization Requirement Update for Vision Services

Effective May 1, 2023, Healthfirst no longer requires authorization for selected vision services.

Open document
Authorization
  
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.