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
June 29, 2026
RE: Expansion of Covered Facial Prosthetics under Medicaid Vision Benefit
June 26, 2026
New York State Medicaid Perinatal Care Standards 2026 Update
June 26, 2026
New York State Department of Health (DOH) Released Updated Billing Guidance for the New York State Patient Centered Medical Home (NYS PCMH) Program
June 16, 2026
Medical Physician Administered Drug Prior Authorization Grids
June 15, 2026
RE: Change to Prior Authorization Procedures for Select Services
June 12, 2026
Important Update – Revised Notice to Providers Regarding Think Cultural E-Learning Site
June 01, 2026
Important Update – Referral Requirements Waived for Gold Members (NYC Employees)
June 01, 2026
National Drug Code (NDC) Requirements for Accurate Claims Processing Effective 7/1/2026
May 05, 2026
Patient Access and Availability Survey
29 Jun
RE: Expansion of Covered Facial Prosthetics under Medicaid Vision Benefit
Dear MetroPlusHealth Provider, Facial prosthetics are custom-made external devices, typically constructed from medical-grade materials, designed to restore the appearance and/or…
26 Jun
New York State Medicaid Perinatal Care Standards 2026 Update
Effective as of February 1st, 2026 Dear MetroPlusHealth Provider, New York State Medicaid has recently updated Perinatal Care Standards to…
26 Jun
New York State Department of Health (DOH) Released Updated Billing Guidance for the New York State Patient Centered Medical Home (NYS PCMH) Program
The New York State Department of Health (DOH) released updated billing guidance for the New York State Patient Centered Medical…
16 Jun
Medical Physician Administered Drug Prior Authorization Grids
Dear MetroPlusHealth Provider, We are committed to streamlining the authorization process for our provider partners. Our Provider Authorizations page offers…
15 Jun
RE: Change to Prior Authorization Procedures for Select Services
Dear MetroPlusHealth Provider, As of July 15, 2026, the services below will change from requiring prior authorization to periodic retrospective…
12 Jun
Important Update – Revised Notice to Providers Regarding Think Cultural E-Learning Site
Dear MetroPlusHealth Provider, As of February 15, 2026, the U.S. Department of Health & Human Services’ Think Cultural Health e-learning…
01 Jun
Important Update – Referral Requirements Waived for Gold Members (NYC Employees)
Dear MetroPlusHealth Providers, We are pleased to share an important update regarding the Gold Plan designed for our NYC workforce…
01 Jun
National Drug Code (NDC) Requirements for Accurate Claims Processing Effective 7/1/2026
Dear Provider, This requirement is pursuant to Section 6002 of the Deficit Reduction Act of 2005, codified at 42 USC…
05 May
Patient Access and Availability Survey
Dear MetroPlusHealth Providers and Office Staff, MetroPlusHealth will be conducting its quarterly Patient Access and Availability Survey beginning on or…
30 Apr
2026 NYSDOH Breast Cancer Surgery Policy Letter
We are writing to share important information regarding a policy update from the New York State (NYS) Department of Health…
30 Mar
New York State Medicaid Coverage of MRI Guided High Intensity Focused Ultrasound for Essential Tremor
TO: All Providers Effective January 1, 2026, per New York State (NYS) Medicaid guidelines, MetroPlusHealth will cover Magnetic Resonance Image…
24 Mar
Breast Cancer Screening Guidelines (Age Criteria Update)
Dear Valued MetroPlusHealth Provider, MetroPlusHealth is committed to keeping our provider network informed on important clinical changes. This notice is…
20 Mar
Reminder: Status Update of OASAS Opioid Treatment Program (OTP) Bundles to Ambulatory Patient Groups (APG) Methodology
TO: ALL OASAS Opioid Treatment Programs Reminder: Status Update of OASAS Opioid Treatment Program (OTP) Bundles to Ambulatory Patient Groups…
09 Mar
MetroPlusHealth – Important Reminder: PCP Replacement for Provider Terminations
Dear Valued Provider, We’d like to share a friendly reminder about the importance of notifying us at least 30 days…
27 Feb
New York State Medicaid Coverage of Tumor Treatment Field Therapy
TO: All Providers Effective 12/1/25, MetroPlusHealth will cover the provision of Tumor Treatment Field Therapy (TTFT) when billed under HCPCS…
26 Feb
Additional Enhanced Rates for Evidence Based Practices (EBPs) within Children and Family Treatment and Support Services (CFTSS)
TO: Children and Family Treatment Support Services (CFTSS) Provider Agencies (Retro) Effective January 1, 2025, the New York State (NYS)…
12 Feb
Medicaid Practitioner Administered Drugs Update: CGT
TO: All Medicaid Providers Effective January 1, 2026, the New York State (NYS) Department of Health has applied to participate…
10 Feb
Long-Term Nursing Home Placement Notice Provider Memo
Dear Nursing Home Administrator: As a valued partner in delivering comprehensive, long-term care to MetroPlusHealth members identified as requiring Long-Term…
06 Feb
MetroPlusHealth is proud to announce our 2026 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…
04 Feb
Discontinuation of Children’s Home and Community Based Services (HCBS) Day Habilitation Service
TO: HCBS Day Habilitation Providers Effective January 1, 2026, Children’s HCBS Day Habilitation will no longer be a covered service…
27 Jan
Coverage of Mobile Crisis Benefit in Essential Plans
Effective as of January 1st, 2026, MetroPlus Health Plan will cover mobile crisis services for Essential Plans to provide immediate…
14 Jan
Healthcare Access Loan Repayment (HEALR) Program
Valued MetroPlusHealth Provider, We would like to remind you that The New York State Medicaid Program is committed to addressing…
07 Jan
Expanding Coverage for Supplemental Breast Cancer Screenings Effective 1/1/26
Dear MetroPlusHealth Provider, This notice serves as a reminder to participating providers of New York State requirements for breast cancer…
07 Jan
Medicaid Update – Updated Implementation Date: Ambulatory Patient Group Weight Adjustment for Phosphate Binders
TO: All Primary Care Providers The previously announced update to the Medicaid policy to include phosphate binder costs in the…
03 Dec
Medicaid Update – Medicaid Coverage of Point of Care Syphilis Testing
TO: All Primary Care Providers Effective immediately, MetroPlusHealth will cover Point of Care (POC) Syphilis Testing to ensure equitable access and screening to help…
Provider Support
last updated: June 3, 2024
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