Posted Sep 30, 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.
Understanding these updates now can help you avoid delays and ensure a smooth experience for your patients and staff.
| Provider Alert Name and Link | Description |
|---|---|
| Prior Authorization Required for Select Services Starting October 1, 2026 | Healthfirst will require prior authorization for select 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. |
Staying current with updates made to the provider manual helps ensure compliance and alignment with Healthfirst requirements.
| Section | Description of Update |
|---|---|
| Section 16.3 (Primary Care Providers) |
Healthfirst is updating the Provider Manual to revise the language surrounding the PCP Scope Reimbursement Policy. |
| Date/Time | Topic | Registration Link |
|---|---|---|
| Oct. 29, 2026 at 12pm | Update on Federal Policy Changes: Medicaid | Register here |
There are no reimbursement policies with an effective date of October 1, 2026.
