Posted on April 26, 2024
Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on the Resources page, click on Behavioral Health/Medical Policies to learn more. Skin and Soft Tissue Substitutes: Updated MassHealth coverage due to new Guidelines for Medical Necessity Determination for Skin Substitutes. Q4159 Affinity, and Q4196, PuraPly now covered for this […]
Posted on April 26, 2024
Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool. Medication Changes Abiraterone edited policy to clarify that the 500mg tabs are excluded and that 250mg are the alternative, updated references and dates Alosetron added max dose restriction, updated references and dates Arcalyst […]
Posted on April 26, 2024
Health New England is committed to reviewing our internal procedures and defining coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, please visit healthnewengland.org/Providers/Resources. Telehealth Services Payment Policy Health New England remains committed to high quality of care for our members, and we recognize […]
Posted on April 26, 2024
Behavioral Health Wellness On February 26, 2024, we notified our network that our Fully Funded Commercial* members will have access to one in-person behavioral health wellness visit per year. These appointments may be with an in-network PCP or licensed behavioral health counselor, and we requested you to bill the visit separately from the annual PCP […]
Posted on April 26, 2024
Attention Providers and Practice Managers: Accurate provider directories are critical to helping our members make educated decisions about their plan choices. Health New England offers an online directory for all products, and hard copies of each directory are available upon request. In an effort to support the Centers for Medicare & Medicaid Services (CMS), MassHealth, […]
Posted on April 24, 2024
The Change Healthcare cyber attack has created hardships for many of our providers and we recognize it will take time for systems to be restored and verified. To help support providers, Health New England has taken the following actions: Claims Submissions and payment files: Change Healthcare access restored Effective April 22, 2024: Health New England […]
Posted on April 1, 2024
Health New England is committed to reviewing our internal procedures and defining coverage and billing guidelines with applicable laws and industry standards to ensure our policies are appropriate. To access payment policies, please visit healthnewengland.org/Providers/Resources. The following policies were reviewed and updated: The following policies are newly added: If you have any questions about the […]
Posted on April 1, 2024
Health New England reviews clinical policies and updates accordingly. These policies reside at healthnewengland.org/Providers/Resources. Once on the Resources page, click on Behavioral Health/Medical Policies to learn more. The following policies were reviewed: Community-Based Acute Treatment/Youth Clinical Crisis Stabilization (CBAT/YCCS) Program and Intensive Community-Based Acute Treatment (ICBAT) Program (Behavioral Health) Youth Clinical Crisis Stabilization services (YCCS) […]
Posted on April 1, 2024
As a reminder, some of our Medicaid/BeHealthy Partnership members may be limited in English proficiency and, by law, have rights mandated by the Commonwealth of Massachusetts under the Limited English Proficiency laws. If you are caring for one of our Medicaid members, MassHealth regulations requires you to provide interpreter services so the member can receive […]
Posted on February 26, 2024
Each year, Health New England reviews gaps in care and access to appointments, and works closely with regulatory entities to ensure programs are in place to meet the needs of our members. The following benefits are in place for 2024: Behavioral Health Wellness Effective 4/1/2024, our Fully Funded Commercial* members will have access to one […]