Starting February 1, 2026, Healthfirst will add prior authorization requirements for selected vision services.
View postTo align with the New York State Medicaid Pharmacy Program policies, Healthfirst will no longer reimburse any contrast agents used for radiological testing for members enrolled in Medicaid Managed Care (MMC) or Personal Wellness Plans (HARP).
View postStarting September 1, 2025, Healthfirst is introducing new prior authorization guidelines for select Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services.
View postRequired Mandatory Annual Compliance Training
View postThe United States Department of Justice has issued new regulations titled the “Final Rule on Preventing Access to U.S. Sensitive Personal Data and United States Government-Related Data by Countries of Concern”, codified at 28 C.F.R. Part 202.
View postEffective September 1, 2025, Healthfirst will implement concurrent review for Psychosocial Rehabilitation (PSR) and Community Psychiatric Supports and Treatment (CPST) services under the Children and Family Treatment and Support Services (CFTSS) benefit.
View postEffective Jan 1, 2025, The Centers for Medicare & Medicaid Services (CMS) finalized several updates to the Medicare Diabetes Prevention Program (MDPP).
View postBeginning July 1, 2025, Healthfirst is issuing updated billing requirements for telehealth services delivered through New York State Office of Mental Health (OMH) licensed and/or designated outpatient programs.
View postReimbursement Updates for eConsults
View postProviders can access Healthfirst tools through Availity Essentials, our new secure provider portal platform.
View postEffective Jan 1, 2025, the Centers for Medicare & Medicaid Services (CMS) issued the 2025 Medicare Physician Fee Schedule Final Rule with key updates impacting Preventive Services for Medicare members.
View postStarting September 3, 2025, Healthfirst providers will need to submit prior authorizations via Optum’s Spine, Pain, and Joint portal as the OrthoNet portal will be discontinued.
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