Posted on November 4, 2020
As you know, the Centers for Medicare & Medicaid Services (CMS) has a process for Medicare coverage determination. This includes National Coverage Determinations (NCDs), which are determined through an evidence-based process. In the absence of a national coverage policy, a service may be covered at the discretion of the Medicare contractor using Local Coverage Determinations […]
Posted on November 4, 2020
Coming soon, Health New England will be working with Healthmap Solutions, Inc. (Healthmap) to provide care coordination services for Medicare Advantage members with chronic kidney disease (CKD) or end-stage renal disease (ESRD). Healthmap is a growing specialty Population Health Management (PHM) company with an industry-leading Kidney Health Management (KHM) program that will greatly benefit our […]
Posted on November 4, 2020
At Health New England, we want our members to know there are alternative methods for managing pain than just simply using medication. While we understand the need for some medication, we want you to be aware of the various options we offer for pain treatment so that you can discuss them with your patients. For […]
Posted on November 4, 2020
New Commercial Plans and Changes for 2021 Thrive First 500: Members have “first dollar” coverage for the first $500 of most medical services, excluding services that are not subject to deductible like Rx. After the first $500 of services are paid by Health New England, the $3,000 deductible will begin to apply. Once deductible is […]
Posted on November 4, 2020
Health New England is currently reviewing our claims pricing and payment system. During this review, we identified that the taxonomy field historically has not been filled in correctly by some providers. While we have outreached to those providers directly, we are sending this reminder about the importance of taking action with your EDI or billing […]
Posted on November 4, 2020
Health New England Appoints New President and CEO We are pleased to announce that Richard Swift has been appointed to the role of President and CEO of Health New England. Richard has been serving as Health New England’s Interim Chief Financial Officer since April 2020. He is an experienced Chief Executive Officer and Chief Financial […]
Posted on October 6, 2020
Health New England is pleased to announce the recent appointment of Ira M. Klein, MD, MBA, FACP, to the role of Vice President and Chief Medical Officer. In this position, Dr. Klein is responsible for ensuring the quality and cost-effectiveness of health care services for Health New England members, and will focus on clinical excellence, […]
Posted on September 14, 2020
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 Centers for Medicare & Medicaid Services (CMS), MassHealth, the […]
Posted on September 14, 2020
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, you are required by MassHealth regulations to provide interpreter services so the member […]
Posted on August 5, 2020
Please see the most recent announcement from the Department of Health and Human Services regarding an extension to its application deadlines. For Medicaid and certain Medicare providers who experienced challenges during Coronavirus, the deadline for your submission has been extended until Friday, August 28, 2020.