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What's New

Posted Feb 07, 2024
Prior Authorization Request - Physical, Occupational, and Speech Therapies

Effective Jan. 1, 2024, Healthfirst resumed responsibility for management of prior authorization (PA) requests for Physical, Occupational, and Speech Therapies.

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Posted Feb 07, 2024
New State Requirements for Provider Compliance Programs

New York State has made changes to provider requirements for starting and maintaining compliance programs.

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Posted Jan 10, 2024
Special Needs Plan Model of Care Annual Evaluation for 2024

This presentation will help educate providers, delegated vendors, and appropriate staff on the Healthfirst Special Needs Plan (SNP) Model of Care (MOC),

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Posted Dec 14, 2023
OrthoNet Descope - FAQ

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of prior authorization (PA) requests for all Physical, Occupational, and Speech Therapies, Podiatry Services, and Vascular Surgery. The following FAQ will help you understand how this change might affect you...

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Posted Nov 14, 2023
Prior Authorizations Eliminated for Substance Use Disorder Prescriptions

This requirement is pursuant to recent changes in law enacted by the New York State Fiscal Year 23-24 Budget Bill

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Posted Oct 24, 2023
Provider Alert: Pharmacist-Administered HPV Vaccines

New York law has expanded the types of immunizations licensed pharmacists can administer to patients 18 years or older, including the HPV vaccine.

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Posted Oct 16, 2023
Healthfirst Cares powered by Welldoc® App now supports prediabetes

Learn more about the self-management features and how it can be used to support your patients with prediabetes!

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Posted Oct 04, 2023
Provider Alert: Behavioral Health Utilization Review Implementation

Healthfirst has implemented a new, trigger-based approach to utilization review for certain acute mental health services for all of our health plans, except for Medicare Advantage plans.

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Posted Oct 02, 2023
Provider Alert: Prohibiting Copays at OTP Facilities

Effective Jan. 1, 2023, New York law prohibits commercial health insurance plans from imposing copayments and coinsurance for treatment delivered at an Opioid Treatment Program (OTP)...

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Posted Sep 25, 2023
Provider Alert - OrthoNet Descope

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of prior authorization (PA) requests previously managed by OrthoNet.

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Posted Sep 25, 2023
FAQ - OrthoNet Descope

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of some prior authorization (PA) requests previously managed by OrthoNet.

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Posted Sep 15, 2023
Inflation Reduction Act Impacts Cost Sharing for Medicare Part B Drugs

Details of cost sharing changes for Medicare Part B drugs due to the Inflation Reduction Act

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