Posted Jul 27, 2026
Learn more about key updates providers should know.
Each month, Healthfirst shares key updates to help you stay informed, prepared, and supported. Below you’ll find important changes and opportunities for the upcoming month. We encourage you to review each section carefully and explore the links provided for full details.
Staying current with updates made to the provider manual helps ensure compliance and alignment with Healthfirst requirements.
| Section | Description of Update |
|---|---|
| Section 3.4 (Appointment Availability and 24-Hour Access Standards) |
This section has been updated to include NYS Access to Care and Appointment Availability standards specific to Essential Plan Members. |
| Date/Time | Topic | Registration Link |
|---|---|---|
| Aug 13, 2026, 9:00am | OIG Readiness Series: Pressure Ulcers and Non-Pressure Ulcer | Register Here |
Review these reimbursement policies to understand how they may impact claims submission and payment.
| Policy Name | Policy Link |
|---|---|
| Allergen Testing | View |
| Biomarker Testing for Autoimmune Rheumatic Disease | View |
| Cardiovascular Disease Risk Assessment | View |
| Colorectal Cancer Screening | View |
| Diagnosis of Vaginitis | View |
| Diagnostic Testing of Common Sexually Transmitted Infections | View |
| Epithelial Cell Cytology in Breast Cancer Risk Assessment | View |
| Evaluation of Dry Eyes | View |
| Flow Cytometry | View |
| Folate Testing | View |
| Helicobacter Pylori Testing | View |
| Hepatitis Testing | View |
| Human Immunodeficiency Virus (HIV) | View |
| Intracellular Micronutrient Analysis | View |
| Lyme Disease Testing | View |
| Onychomycosis Testing | View |
| Pancreatic Enzyme Testing for Acute Pancreatitis | View |
| Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing | View |
| Pediatric Preventive Screening | View |
| Prescription Medication and Illicit Drug Testing in the Outpatient | View |
| Prostate Specific Antigen (PSA) Testing | View |
| Salivary Hormone Testing | View |
| Serum Tumor Markers for Malignancies | View |
| Thyroid Disease | View |
| Urinary Tumor Markers for Bladder Cancer | View |
| Venous and Arterial Thrombosis Risk Testing | View |
There are no prior authorization requirements with an effective date of August 1, 2026.
