EyeMed 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.
View postAs part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, Healthfirst will reimburse providers for pediatric vaccine counseling visits for Medicaid and Personal Wellness Plan (HARP) members under 21 years of age.
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View postStarting March 20, 2025, Healthfirst will add prior authorization requirements for selected medical services. These changes are part of Healthfirst’s ongoing responsibility to evaluate its medical policies compared to the latest scientific evidence and specialty society guidance.
View postStarting January 1, 2025, Healthfirst is creating new service codes to accurately account for Linked and Mutual Visits provided to Medicaid, Personal Wellness Plans (HARP), Senior Health Partner (SHP) and CompleteCare (CC) members.
View postStarting January 1, 2025, Providers will need to bill Medicaid Fee-for-Service or Member’s Medicaid Coverage for Healthfirst Connection Plan Members’ cost sharing.
View postAs part of the Inflation Reduction Act, changes are being instituted to help make healthcare more affordable. These changes go into effect on January 1, 2025, and could affect many of your patients.
View postStarting January 1, 2025, New York State of Health is implementing a Diabetes Cost-Sharing Reduction initiative to make services more accessible and affordable. Learn more about these cost-sharing reductions in this Provider Alert...
View postTo understand the timing and delivery of perinatal services, the New York State Department of Health is requiring changes to claims submissions for perinatal services for Medicaid, Personal Wellness Plans (HARP), Medicaid Advantage Plans, and Connection Plan lines of business.
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View postHealthfirst has removed prior authorization requirements from all antiretroviral medications prescribed for the treatment or prevention of Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS) for all Healthfirst plans.
View postStarting January 1, 2025, Healthfirst will cover Crisis Residence Services and Mobile Crisis Services for our Essential Plan (EP), Leaf & Leaf Premier Plan members (also known as our Qualified Health Plans).
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