Posted on February 2, 2022
Medicare Open Enrollment Period – January 1 through March 31 Did you know that Medicare offers beneficiaries who are enrolled in a Medicare Advantage plan one last opportunity to switch their plan during the Medicare Open Enrollment Period (OEP)? The Medicare Open Enrollment period runs from January 1 to March 31 each year. During this […]
Posted on October 29, 2021
Effective 1/1/2022, our Medicare Advantage product has added two PPO plans, one called Compass and the other Compass Premier, and a new travel benefit under these plans. We will also be closing the Select (HMO-POS) plan effective 12/31/2021. It is important when making appointments with our Medicare members that you reference their ID Card to […]
Posted on October 29, 2021
Each month, Health New England reviews clinical criteria and policies with our Clinical Care Advisory Committee and Medical Technology Assessment Committee. When changes occur, we update policies, if applicable, and inform our network accordingly. Below are recent updates you need to know when caring for our members: For Fully Funded Commercial and Medicaid, the following […]
Posted on March 31, 2021
In addition, the following coverage determinations apply to these HCPC codes:
Posted on September 27, 2019
Health New England’s formularies can be accessed on healthnewengland.org using the “Find A Drug” tool at the top of the page. The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and BeHealthy Partnership/Medicaid. Each formulary includes the tier […]
Posted on September 27, 2019
Effective 1/1/2020, the calendar year limit for physical and occupational therapy is changing to a combined 60 visits per calendar year. This calendar year limit change does not apply to services that are part of the home health plan or services provided to treat autism spectrum disorder. Those services require a prior approval. A communication […]
Posted on September 27, 2019
Effective 1/1/20, one of our self-funded employer groups, Baystate Health, will be covering 100% of the cost of the Cologuard test for their employees and NO prior authorization is needed. As a provider, you will need to see your patient’s member ID card to know if a prior authorization is needed prior to ordering the […]
Posted on February 13, 2018
Health New England is committed to keeping all of our providers informed of plan changes and other updates related to our lines of business. We would like to inform you of an upcoming change in our Medicaid business. Earlier this year, we were informed by MassHealth that Health New England has not been awarded a new […]
Posted on April 22, 2016
Health New England has a number of important updates that may have an impact on your practice. Please review the following updates: Urine Drug Screen Payment Policy ClaimsXTen CMS Clinical Edit Update Pharmaceutical Waste Payment Policy Medicare First Tier, Downstream and Related Entities Training Updates on a number of Behavioral Health and Medical Clinical Policies […]