Providers can access Healthfirst tools through Availity Essentials, our new secure provider portal platform.
View postThe New York State Department of Health requires Medicaid members diagnosed with End Stage Renal Disease (ESRD) to apply for Medicare.
View postNew York State will resume standard annual recertification procedures for off-exchange Medicaid, Personal Wellness Plan (HARP), Life Improvement Plan (LIP), CompleteCare (CC), and Senior Health Partners (SHP) members.
View postThe New York State (NYS) Office of Mental Health (OMH) is launching a redesign of the Personalized Recovery Oriented Services (PROS) program, effective April 1, 2025.
View postACEs screenings conducted in primary settings has been expanded to cover one lifetime screening for Medicaid members between 21 to 65 years of age. Children and adolescents up to 21 years of age continue to receive coverage for annual ACEs screenings as appropriate and medically necessary.
View postProviders will no longer need to submit prior authorization requests to Evicore for select codes.
View postLicensed Home Care Service Agencies are required to obtain and document a physician order before providing personal care services and private duty nursing to Senior Health Partner, CompleteCare, and Medicaid Members.
View postHere’s what you need to know about the annual Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey.
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View postAscenia/Bayer (Contour and Contour Next) products
View postStarting April 6, 2025, Healthfirst will add prior authorization requirements for selected medical services.
View postEyeMed manages Healthfirst’s prior authorization for surgical and therapeutic vision services as well as network management, related member and provider service calls, and claims payment for routine vision and medical optometry services.
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