Posted on July 2, 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. Breast Surgery Updated to remove reference to Schnur Sliding Scale as this scale is no longer used No change to effective date of 8/1/2024 Prostate Procedures (BPH […]
Posted on May 16, 2024
ATTENTION: HOME HEALTH, SKILLED NURSING, OT/PT SPEECH THERAPISTS, PCA The Massachusetts Executive Office of Health and Human Services (EOHHS) is hosting an upcoming Electronic Visit Verification (EVV) Overview Forum to inform providers, health plans, and other key stakeholders of the EVV solution and implementation. Please distribute to your Home Health, Personal Care Services, and Aging Services […]
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) […]