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Fidelis Care has received notice from the Office of the Medicaid Inspector General (OMIG) of new compliance program requirements for Medicaid participating providers. Effective April 2020, for New York State (NYS) Social Services Law (SSL) §363-d, and effective December 28, 2022, for the corresponding regulations at 18 New York Codes, Rules and Regulations (NYCRR) Subpart 521-1, NYS Medicaid providers shall adopt, implement, and maintain effective compliance programs aimed at detecting fraud, waste, and abuse in the NYS Medicaid program.   Who is Required to Have a Compliance Program? NYS Social Services Law (SOS) § 363-d and Title 18 of the New York Codes, Rules

Fidelis Care is continuing efforts to ensure compliance with Electronic Visit Verification (EVV) requirements under the 21st Century Cures Act. As part of this work, Fidelis Care has partnered with HHAeXchange (HHAX), a home care management solutions vendor.  Providers may choose to use HHAX to submit claims; however, the system must be used for EVV. Claims associated with visits that do not have validated EVV may be denied or subject to recovery. What Providers Need to Know HHAX must be used for EVV validation, even if claims are submitted through another method. Visits without validated EVV may result in claim denials

At Fidelis Care, provider feedback is essential to how we improve our programs, processes, and overall experience working with our network. To support more frequent and meaningful collaboration, we’re excited to introduce the Provider Advisory Community—a new online forum designed specifically for providers. What Is the Provider Advisory Community? The Provider Advisory Community is a private, online space where participating providers can share insights and perspectives on topics such as: Administrative and clinical challenges Digital tools and resources Opportunities for improvement The overall experience working with Fidelis Care Participants will also get an early look at upcoming initiatives and updates, allowing Fidelis Care

To help vulnerable individuals who struggle with extreme heat, NY State of Health is again offering free air conditioners through its Essential Plan Cooling Program. The program runs from April 15, 2026, to August 31, 2026, or until supplies run out. During the summer, patients living in excessive heat have a higher risk of death and hospitalization from chronic conditions. By having A/C units installed in their homes, the program can improve health outcomes and prevent emergency visits and hospitalizations. Please notify your patients currently enrolled in the Essential Plan that they may be eligible if they have one of these health conditions:

Fidelis Care will host three Provider Office Hours in May 2026. During the webinar, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – May 2026   Topic: Fidelis Care – Back to Basics When:  Thursday, May 14th – 9AM – 10AM EST Click here to register*   Topic: Fidelis Care and Wellcare Quality Programs When:  Wednesday, May 20th – 10AM – 11AM EST Click