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Documentation & Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Neoplasm of the Meninges

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 Neoplasm of the Meninges.

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Clinical Documentation Improvement
  
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.

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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.

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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)*

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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
  
Documentation & 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
  
Documentation & 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.

Open document
Provider Events
  
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