HF Logo HF Logo

What's New

Important Posted Nov 29, 2024
Diabetes Cost-Sharing Reduction for Essential Plan, Leaf Plan, and Leaf Premier Plan Members

Starting 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 post
Important Posted Nov 25, 2024
Changes to Claims Submissions for Prenatal and Postpartum Services

To 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.

View post
Posted Nov 20, 2024
Provider Education Events

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

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

Ensure you remain current on the most recent changes

View post
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.

View post
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).

View post
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.

View post
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.

View post
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.

View post
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.

View post
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.

View post
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.

View post