Friday
• Posted by Provider Relations
NY State of Health has notified health plans and members of Essential Plan 200-250 (also known as Essential Plan 5) that plan coverage will end. The last day of coverage is June 30, 2026. Your patients’ coverage remains the same through that date.
This change is due to anticipated cutbacks in federal funding, according to NY State of Health. It only affects people whose income is between 200% and 250% of federal poverty level. Your patients in Essential Plan 1–Essential Plan 4 are not impacted.
Impacted individuals received a letter on April 1 from NY State of Health outlining the timeline for
Last Week
• Posted by Fidelis Care
With all the increases in technology, it’s easy to forget that healthcare starts with the people who show up every day wanting to make a difference. At Fidelis Care, we are proud to work with caring and conscientious doctors across New York State.
Whether they are seeing patients in their office or administering care in a hospital or emergency room, doctors are the lifeblood of our healthcare system.
March 30 is National Doctors Day. On this annual observance, Fidelis Care shares our gratitude to the doctors and healthcare professionals who support the health and wellness of the members and local communities
Last Week
• Posted by Provider Relations
The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2026.
The following codes have been added to the Medicaid Authorization Grid and requires prior authorization:
III. Outpatient surgery: The following services require prior authorization:
D. Skin surgery and other dermatological procedures:
· Only the following codes continue to require authorization for any place of service: A2030, A2031, A2032, A2033, A2034, A2035, A2036, A2037, A2038, A2039, A2040, A2041, A2042, A2043, A2044, A2045, G0681, G0682, G0683, G0684, 11200, 11201, 15271, 15274, 15275, 15276, 15734, 15769-15776, 15778-15829, 17340-17999, Q4101, Q4121, Q4186, Q4195, Q4196, Q4354, Q4355, Q4356, Q4357, Q4358, Q4359, Q4360,
2026/3/23
• Posted by Provider Relations
Pursuant to past guidance by the New York Department of Health (NYDOH), claims submitted under the medical benefit for medications must include a valid National Drug Code (NDC). Claims that do not include an NDC, or that include an NDC that does not match the billed HCPCS code, may be denied and/or not eligible for reimbursement.
Billing Guidance Reminders
Submit the HCPCS code that accurately reflects the drug administered.
Report the 11-digit NDC (5-4-2 format, no spaces or hyphens) that corresponds to the actual product administered.
Ensure the NDC matches the HCPCS code and that both align to the service documented