Posted on May 28, 2022
Effective July 1, 2022, for our Commercial Members,* Health New England will not cover services related to Autism Spectrum Disorder (ASD) provided under an individualized education program, whether provided by school personnel or by third-party contractor or vendors at the direction of the school personnel. *May be applicable to some Self-Funded plans. Please refer to […]
Posted on May 28, 2022
Effective July 1, 2022, for our Commercial Members,* Health New England will not cover Occupational and Physical Therapy services for children with developmental delays that are covered by MGL Chapter 71B in Massachusetts (referred to as Chapter 766) or C.G.S.A. § 10-76a through 10-76g, inclusive, in Connecticut, unless such services are Medically Necessary and meet […]
Posted on May 28, 2022
As a reminder, Health New England doesn’t require the taxonomy for the majority of their claims. However, in some cases, the taxonomy is cross walked to your NPI to ensure accurate payment calculations. In no way is this a requirement to complete your 837 transaction, and Health New England nor your trading partner will perform […]
Posted on May 28, 2022
Effective July 1, 2022, Health New England will cover the following services related to COVID-19 with no cost share. This applies to members seeking care with in-network providers as well as out-of-network providers. Emergency Services Inpatient Services Cognitive Rehabilitation Services Diagnostic and Laboratory Services Medically Necessary Testing Immunizations For more information, please call Provider […]
Posted on May 28, 2022
The following prescription drug coverage will be effective July 1, 2022, for our BeHealthy Partnership (Medicaid) members:
Posted on May 28, 2022
The following prescription drug coverage will be effective July 1, 2022, for Health New England Commercial plan members:
Posted on May 28, 2022
Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool.
Posted on May 28, 2022
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. Please note, new/revised policies may not appear until closer to the effective date.
Posted on April 26, 2022
Many of our Medicare members are beginning to select our Medicare Supplement plans, and with this opportunity, there are important reminders for providers when our members seek care. Our Medicare Supplement members have Original Medicare as their primary coverage and our plan is a supplement to help cover some leftover balances depending on the plan […]
Posted on April 26, 2022
Below is some important information regarding Spinraza and Zolgensma and our Commercial Members. Beginning May 27, 2022, Providers will continue to follow Health New England’s process through Magellan, but Accredo Health Services will exclusively distribute Spinraza and Zolgensma. Once the approval has been obtained from Magellan, you may order the medication directly from Accredo at […]