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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)*

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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.

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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.

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Medicare
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Hyperparathyroidism

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for Hyperparathyroidism.

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Clinical Documentation Improvement
  
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...

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Recertification
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Metastatic Cancer/ Secondary Malignant Neoplasm

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for common types of Metastatic Cancer/Secondary Malignant Neoplasm.

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Clinical Documentation Improvement
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 4: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 4) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 3: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 3) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 2: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 2) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Book 1: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers

(Conference Book 1) Virtual Continuing Medical Education (CME) Conference: Autism Spectrum Disorders for the Primary Care Practitioner and Other Providers This event is jointly offered by Healthfirst and SUNY Downstate Health Sciences University.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 2: Spring 2023 Provider Symposium

(Panel 2 booklet) The theme for the May 19, 2023 Healthfirst Spring Symposium is "Artificial Intelligence in Healthcare: Improving Health Outcomes and Advancing Equity with New Tools."

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 1: Spring 2023 Provider Symposium

(Panel 1 booklet) The theme for the May 19, 2023 Healthfirst Spring Symposium is "Artificial Intelligence in Healthcare: Improving Health Outcomes and Advancing Equity with New Tools."

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Provider Events
  
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