Posted on February 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. The following policies were reviewed: Drug Testing in Substance Use Disorder treatment and Pain Management Name changed from Drug Testing Minor changes to criteria No coding changes […]
Posted on February 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 February 26, 2024
Health New England is committed to reviewing our internal procedures and define 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: If you have any questions about the information in this notice, please contact […]
Posted on February 16, 2024
Point32Health, the not-for-profit parent company of Harvard Pilgrim Health Care and Tufts Health Plan, announced today it has signed a definitive agreement with Baystate Health to acquire its subsidiary, Health New England.
Posted on January 30, 2024
Health New England is committed to reviewing our internal procedures and define 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: Anesthesia Services Payment Policy – added the QZ modifier
Posted on January 30, 2024
Health New England’s formularies are located at healthnewengland.org. At the top of the page, use the “Find A Drug” tool. Changes to policies: New Policies: For more information, please do not hesitate to call our Provider Experience Department at (800) 842-4464, extension 5000, or send an email to providerrelations@hne.com.
Posted on January 12, 2024
Effective January 9 – April 1, 2024, for our Commercial (fully funded),* BeHealthy Partnership and Medicare Advantage members, Health New England will: Allow good faith admissions to skilled nursing facilities (SNF) and acute rehabilitation facilities from the acute care setting without prior authorization. Cover the initial 7 days of the SNF/acute rehab stay. Conduct retrospective […]
Posted on December 28, 2023
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. Endothelial Keratoplasty Retired effective 1/1/2024 Non-Covered, Experimental and Investigational Services Retired effective 1/1/2024 – see Medical Necessity Lipodystrophy Syndrome – HIV associated Effective 3/1/2024 Name changed […]
Posted on December 28, 2023
Medicare Advantage 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 Advantage Open Enrollment Period (MA OEP)? The Medicare Advantage Open Enrollment period runs from January 1 to March 31 […]
Posted on December 28, 2023
Health New England reviews our Provider Manual regularly and notifies you when there are updates. Most recently, we clarified the Post-Service Review definition in our Medical Management section under Utilization Management. We provided more content to this section, which aligns with the policies and procedures we have always followed. Go to https://healthnewengland.org/provider-manual to learn more. […]