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 04, 2024
Update on the Change Healthcare (CHC) Outage: Claims Timely Filing Requirements to be Reinstated July 1, 2024
June 04, 2024
RE: NYS 2023-2024 BUDGET-SUBPART B, AMENDMENTS TO INCLUDE CRISIS RESIDENCE FACILITIES
April 01, 2024
Re: MetroPlusHealth’s Essential Plan (EP) Members Who Report Becoming Pregnant
March 13, 2024
IMPACTED PLANS: MEDICAID, AND HIV SNP NEW YORK STATE MEDICAID COVERAGE OF RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY (NIRSEVIMAB) FOR INFANTS
March 13, 2024
RE: Billing Guidance for Delivering Services in a Language Other Than English (LOE) Within MHOTRS Programs Impacted Plans: Medicaid, HARP, HIV SNP, AND MAP
March 13, 2024
APPROVAL OF THE NOVAVAX COVID 19 VACCINE
13 Jun
Concurrent Review Memo for Crisis Residence Facilities
TO: CRISIS RESIDENCE FACILITIES Effective May 3, 2024, per the NYS 2023-2024 Budget – Subpart B, modification for previously existing…
05 Jun
MetroPlusHealth is proud to announce our 2024 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 Jun
Update on the Change Healthcare (CHC) Outage: Claims Timely Filing Requirements to be Reinstated July 1, 2024
As a result of the Change Healthcare cyberattack, MetroPlusHealth temporary extended claim appeals partially paid, fully paid, or denied, and…
04 Jun
RE: NYS 2023-2024 BUDGET-SUBPART B, AMENDMENTS TO INCLUDE CRISIS RESIDENCE FACILITIES
TO: METROPLUSHEALTH PARTICIPATING PROVIDERS – CRISIS RESIDENCE FACILITIES Effective May 3, 2024, per the NYS 2023-2024 Budget – Subpart B,…
01 Apr
Re: MetroPlusHealth’s Essential Plan (EP) Members Who Report Becoming Pregnant
Beginning April 1st, 2024, MetroPlusHealth’s Essential Plan (EP) members who report becoming pregnant, will have their copays for all services…
13 Mar
Rx Carveout
Beginning April 1, 2023, all Medicaid members enrolled in MetroPlusHealth Medicaid, Partnership In Care, and Enhanced (HARP) plans will receive…
13 Mar
Providers must comply with the DOH, OMH, OASAS, and OPWDD issued Billing Updates to applicable codes, modifiers, and Place of Service (POS) requirements, for Medical and Mental Health Services.
Frequently Asked Questions: CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency Read Notice Here
13 Mar
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…
13 Mar
PROVIDER SEMINAR: CANCER AND ENVIRONMENT
Wednesday, June 21st , 2023 | 9:30 AM – 5:00 PM Roy and Diana Vagelos Education Center Auditorium & via…
13 Mar
IMPORTANT REMINDER: Prescription Monitoring Program Registry
Effective August 27, 2013, most prescribers are required to consult the Prescription Monitoring Program (PMP) Registry when writing prescriptions for…
13 Mar
URGENT MESSAGE: YOUR PATIENTS WILL LOSE THEIR MEDICAID COVERAGE UNLESS THEY RENEW
Dear Valued Provider: If you don’t help your patients act soon, they will lose their Medicaid coverage. While Medicaid members…
13 Mar
Updated Provider Letter Regarding Foster Care 2023
As a MetroPlusHealth network provider, you may find yourself in a position to provide trauma-informed care to Medicaid Managed Care…
13 Mar
NOTICE TO OUR PROVIDERS REGARDING NEW YORK STATE MEDICAID’S REIMBURSEMENT POLICY FOR ADMINISTRATION OF COVID-19 VACCINES
The New York State Department of Health has updated the coverage policy and billing guidance document regarding New York State…
13 Mar
BILLING REQUIREMENT CHANGES AND UPDATES FOR CHILDREN’S HCBS AND CFTSS SERVICES
Effective December 1, 2023, NYS is implementing a billing change that will allow claims for Children’s Home and Community Based…
13 Mar
Self-Disclosure Notification Protocol
The Office of Mental Health (OMH) is informing Providers of their responsibility to notify OMH when a self-disclosure of a…
13 Mar
COMMUNITY HEALTH WORKER SERVICES FOR PREGNANT AND POSTPARTUM MEMBERS
RETROACTIVE: Effective October 1, 2023, MetroPlusHealth will reimburse Community Health Worker (CHW) services* for pregnant and postpartum populations. Medicaid members…
13 Mar
APPROVAL OF THE NOVAVAX COVID 19 VACCINE
Effective October 3, 2023, the Federal Drug Administration (FDA) announced the approval of the updated 2023–2024 monovalent XBB.1.5 variant Novavax…
13 Mar
RE: Billing Guidance for Delivering Services in a Language Other Than English (LOE) Within MHOTRS Programs Impacted Plans: Medicaid, HARP, HIV SNP, AND MAP
Effective October 1, 2023, The NYS Office of Mental Health (OMH) and the NYS Department of Health (DOH) have updated…
13 Mar
IMPACTED PLANS: MEDICAID, AND HIV SNP NEW YORK STATE MEDICAID COVERAGE OF RESPIRATORY SYNCYTIAL VIRUS MONOCLONAL ANTIBODY (NIRSEVIMAB) FOR INFANTS
Effective October 1, 2023, New York State (NYS) is providing coverage for the administration of Nirsevimab for infants through the…
13 Mar
IMPORTANT MESSAGE FOR OUR PROVIDERS:
The New York State Office of Addiction Services and Supports (OASAS) has made the overdose reversal medication Naloxone (Narcan) and…
13 Mar
HELP PATIENTS PREVENT DIABETES WITH LIFESTYLE TIPS
Lifestyle changes can make a big difference in preventing diabetes. Learn More
13 Mar
URGENT MESSAGE: YOUR PATIENTS WILL LOSE THEIR MEDICAID COVERAGE UNLESS THEY RENEW
For More Information
13 Mar
Important Information on Covid 19 Services Coverage
As of May 12, 2023, MetroPlusHealth will no longer cover COVID testing from out of network providers including laboratory PCR…
13 Mar
NOTIFICATION TO PROVIDERS REGARDING CHANGES TO COMPLIANCE CERTIFICATION REQUIREMENT
Providers who submit electronic claims to the New York State Medicaid Program are required by MetroPlusHealth to retain in the…
last updated: June 3, 2024
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