Posted on October 29, 2026
Health New England is making the following changes to our Medicare Advantage plan choices for 2027. Berkshire County ONLY No longer offering Medicare Value HMO and Medicare Compass PPO plans for 2027. New plan offering for 2027: Medicare Standard HMO Hampden, Hampshire & Franklin Counties ONLY No plan closings New plan offering for 2027: […]
Posted on October 29, 2026
As a reminder, Health New England implements National Coverage Determinations (NCD) and Local Coverage Determinations (LCD) to align our claims payment system against accepted industry rules and coding guidelines. The following edit rules will be implemented: NCD – Lung Cancer Screening with Low Dose Computed Tomography (LDCT) (210.14) Additionally, as part of our ongoing […]
Posted on October 29, 2026
Beginning in December 2026, EviCore by Evernorth will be leading online orientation sessions designed to support providers and their staff in understanding and navigating the new program requirements for MSK (Spine & Joint), Cardiology, and Radiation Oncology. These sessions will cover: An overview of the prior authorization process How to access and use resources on […]
Posted on October 29, 2026
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice. To find policies noted below, please visit healthnewengland.org/Providers/Resources. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension […]
Posted on October 29, 2026
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. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, […]
Posted on October 1, 2026
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. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, […]
Posted on September 30, 2026
Please read the following update related to various Health New England programs and changes that may have an impact on your patients and/or your practice. To find policies noted below, please visit healthnewengland.org/Providers/Resources. If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension […]
Posted on September 30, 2026
Commercial Line of Business – Pelvic Exam Denial Policy Change At Health New England, we continuously evaluate opportunities to improve the provider and member experience. Based on your feedback, we have made the decision to remove denials for CPT 99459 Pelvic exam services for our Commercial Line of Business. Effective July 1, 2026, claims submitted […]
Posted on September 30, 2026
The Medicare Annual Enrollment Period (AEP) begins on October 15 and runs through December 7. If you have patients who are 65 or older and have questions about Medicare, please have them contact Health New England to speak with one of our Medicare Specialists at (413) 787-0010, TTY 711. We are available from 8:00 a.m. […]
Posted on September 30, 2026
Commercial and Medicare Lines of Business Health New England has again partnered with LetsGetChecked to provide at-home testing for members to address gaps in evaluations for FIT, A1C, and Kidney Health. Commercial members – FIT and A1C Medicare members – FIT and KED You may have patients who opt into receiving a home test kit […]