Our providers know that everything from rules and regulations to best practices and cutting-edge innovations are always evolving across the healthcare landscape.
From timely reminders about combating antibiotic resistance to updates on Medicaid, Medicare, and more, our news service gives our providers the up-to-date information they need to deliver the best care possible.
Important & Urgent Notifications
February 11, 2025
MetroPlusHealth’s Partnership with BetterDoctor: FAQ
February 11, 2025
MetroPlusHealth is proud to announce our 2025 Provider Pay for Performance (P4P) program
February 05, 2025
COVERAGE AND REIMBURSEMENT OF EVISITS
February 04, 2025
Removal of Primary Care Provider (PCP) Name on ID Card
January 24, 2025
Expanded Reimbursement To Population For Adverse Childhood Experiences Screening
January 24, 2025
Health Homes Serving Children Providers
January 15, 2025
Self-administered Hormonal Contraception Medication Without a Prescription
January 08, 2025
NCD PrEP for HIV Prevention 2025
December 31, 2024
Health Homes Serving Children Providers
11 Feb
MetroPlusHealth’s Partnership with BetterDoctor: FAQ
1. What is BetterDoctor? BetterDoctor, a division of Quest Analytics®, provides reliable provider network and verification services. By using the…
11 Feb
MetroPlusHealth is proud to announce our 2025 Provider Pay for Performance (P4P) program
This program rewards providers who meet specific goals for delivering quality and efficient care goals to MetroPlusHealth members enrolled in…
05 Feb
COVERAGE AND REIMBURSEMENT OF EVISITS
TO: MEDICAID PROVIDERS (Retro) Effective October 1st, 2023, per New York State (NYS) Medicaid guidance update, MetroPlusHealth is allowing reimbursement…
04 Feb
Removal of Primary Care Provider (PCP) Name on ID Card
Starting November 1, 2024, MetroPlusHealth member ID cards for newly enrolled members or reissued member cards, will no longer reflect…
24 Jan
Expanded Reimbursement To Population For Adverse Childhood Experiences Screening
IMPACTED PLANS: MAINSTREAM MEDICAID, HIV SNP, and HARP Dear MetroPlusHealth Provider: Effective January 1, 2025, per updated mandate issued by…
24 Jan
Health Homes Serving Children Providers
IMPACTED PLANS: Medicaid and HIV SNP Effective October 1, 2024, the New York State Department of Health (NYSDOH) has received…
15 Jan
Self-administered Hormonal Contraception Medication Without a Prescription
Effective January 1, 2024, Governor Kathy Hochul authorized New York State pharmacists to dispense three types of self-administered hormonal contraception…
08 Jan
NCD PrEP for HIV Prevention 2025
Effective Date:9/30/24 Impacted Plans:MetroPlus UltraCare, MetroPlus Medicare Advantage and MetroPlus Platinum. Dear MetroPlusHealth Provider: As of September 30, 2024, MetroPlus…
31 Dec
Health Homes Serving Children Providers
DATE: 10/15/2024 – NYS DOH Memo Release IMPACTED PLANS: Medicaid and HIV SNP Dear MetroPlusHealth Provider, DOH has released guidance…
31 Dec
ALL Children HCBS and Health Home Providers
DATE: 12/01/24 IMPACTED PLANS: Child Health Plus (CHP) Dear MetroPlusHealth Provider, Effective January 1, 2025, per DOH mandate, MetroPlusHealth will…
24 Dec
NY 1332 Waiver – Diabetic and Pregnant Members for QHP
Beginning January 1st, 2025, MetroPlusHealth’s Qualified Health Plan (QHP) members who report becoming pregnant, will have their cost-sharing for all…
23 Dec
ALL Children’s HCBS Providers
IMPACTED DATE: 10/24/24 IMPACTED PLANS: Medicaid and HIV SNP Effective 10/24/2024, per New State Department of Health (NYSDOH) mandated guidelines,…
23 Dec
Health Homes Serving Adults and/or Children
DATE: 11/12/2024 – DOH Memo Release IMPACTED PLANS: Medicaid, HIV SNPs, and HARP DOH has released guidance to notify that…
08 Dec
Mandated Rate Update: ACT Reimbursement and Billing Changes
DATES: 10/01/2023 (Retroactive) and January 1, 2025 (Prospective) RE: ALL BEHAVIORAL HEALTH PROVIDERS Effective 10/01/2023 (Retroactive), OMH has released guidance…
12 Nov
BEHAVIORAL HEALTH PROVIDERS RE: SCHOOL BASED MENTAL HEALTH CLINICS IN MENTAL HEALTH OUTPATIENT TREATMENT REHABILITATIVE SERVICES (MHOTRS) PROGRAM
Effective January 1, 2024, OMH has released guidance that is applicable to commercial reimbursement of School Based Mental Health Services…
22 Oct
Important Reminder: Model of Care Training due by 12/31/2024
Important Notice To All Our Providers Tuesday, December 31, 2024, is the deadline for you to complete the MANDATORY Annual…
08 Oct
Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services After the Coronavirus Disease 2019 Public Health Emergency
Comprehensive updated guidance regarding use of telehealth (including telephonic services) and billing guidance and criteria following the end of the…
23 Sep
2024 NYSDOH Breast Cancer Surgery Policy Letter
Research has consistently demonstrated that patients undergoing breast cancer surgery at high-volume facilities experience higher five-year survival rates. As a…
16 Sep
Payment Policy: E&M and Preventive Medicine Policy
LOB: Medicaid, HIV SNP, CHP, MetroPlus Gold, Goldcare I&II, QHP, Essential, HARP 1. POLICY DESCRIPTION: This payment policy provides guidelines…
16 Sep
Updated Foster Care Provider Education Letter
As a MetroPlusHealth network provider, you may find yourself in a position to provide trauma-informed care to Medicaid Managed Care…
12 Sep
Model of Care Webinar
> For more information | > Register for the Webinar | > Medicare Model Provider Training Deck
11 Sep
Managed Long Term Care (MLTC) Policy 24.01: Non-Emergency Medical Transportation and Social Adult Day Cares
Division of Health Plan Contracting and Oversight Date of Issuance: July 1, 2024 Effective Date: January 1, 2025 Purpose: The…
10 Sep
End of Change Healthcare Appeal Timeframe
As a result of the Change Healthcare cyber-attack dated February 21, 2024, MetroPlusHealth temporarily extended claim appeals for impacted claims…
28 Aug
Status Update of OASAS Part 822 Comprehensive Outpatient Treatment Program (COP)
TO: OASAS Part 822 Comprehensive Outpatient Programs (COP) Dear MetroPlusHealth Provider, Effective August 1, 2024 OASAS has directed programs to…
28 Aug
Status Update of OASAS Opioid Treatment Program (OTP) Bundles to Ambulatory Patient Groups (APG) Methodology
TO: ALL OASAS Opioid Treatment Programs Dear MetroPlusHealth Provider, Effective July 1 – Nov. 3, 2024, providers have the option…
Provider Resources
last updated: June 3, 2024
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