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What's New

New Posted Nov 20, 2024
Provider Education Events - new session recordings posted

Together, we can improve patient outcomes. Join us at a provider education workshop, training, or event.

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Posted Nov 01, 2024
Medications Requiring Prior Authorization Under the Medical Benefit

Ensure you remain current on the most recent changes

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Important Posted Oct 31, 2024
Prior Authorization No Longer Required for Antiretroviral Prescription Medications

Healthfirst 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.

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Posted Oct 23, 2024
Crisis Residence and Mobile Crisis Services Now Covered for Healthfirst Essential Plan, Leaf, and Leaf Premier Members

Starting 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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Posted Oct 15, 2024
Two Additional Prior Authorization Codes Managed by EyeMed Effective Jan. 1, 2025

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.

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Posted Oct 11, 2024
Changes to OASAS Comprehensive Outpatient Treatment Programs and Updated Billing Guidance

The New York State Office of Addiction Service and Supports (OASAS) is implementing several changes to integrate care within the OASAS outpatient clinic regulatory structure.

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Posted Sep 26, 2024
Foster Care Provider Education Letter

This updated provider education letter outlines key guidance providers should be mindful of when delivering care to Medicaid enrolled children/youth in direct placement foster care and in the care of Voluntary Foster Care Agencies.

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Posted Sep 23, 2024
Documentation and Coding Updates

We're committed to helping providers and clinical coders with the accurate coding of patients’ health records.

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Posted Aug 26, 2024
See the latest news about Availity Essentials™

Providers can access Healthfirst tools through Availity Essentials, our new secure provider portal platform.

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Posted Jul 25, 2024
Reimbursement Update for electronic consultations (eConsults)

The New York State (NYS) Medicaid fee-for-service (FFS) program will reimburse for eConsults, effective April 1, 2024.

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Posted Jul 19, 2024
Prior Authorization Request Enhancements for Select Outpatient Service Authorizations

Learn how to obtain faster authorizations through our Online Authorization Request tool.

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Posted Jun 10, 2024
Public Health Emergency (PHE) Flexibilities Related to the Medicaid Children’s Waiver and Health Home Services

The New York State Department of Health (NYSDOH) has issued guidance on Public Health Emergency (PHE) flexibilities...

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