Provider News and Updates
In the rapidly transforming world of healthcare, VNSNY CHOICE understands how important it is for you to stay up to date on changes that affect you, your practice, and your patients. Below are notices, recommendations, and updates that can help you keep track of changing standards and regulations. Check back regularly for new postings.
Guideline and Policy Updates
For VNSNY CHOICE Total (HMO D-SNP) Providers
New Guidelines for Telehealth Interventions in four HEDIS Quality Measures
(For VNSNY CHOICE Total Providers Only)
On January 1, 2019 an important change was implemented that may continue to affect your patients. In order to prevent prescription drug abuse and improve the safety of prescription medications, CMS (Centers for Medicare and Medicaid Services), requires all Part D plans to follow opioid safety edits and a Drug Management Program. Recently, VNSNY CHOICE sent a letter to all in-network CHOICE Total prescribers to help keep you informed about what you need to know. You can also find more information about these requirements on our Opioid Safety Edits page.
For SelectHealth from VNSNY CHOICE Providers
Starting October 1, 2019, VNSNY CHOICE SelectHealth covers medically necessary ovulation enhancing drugs and the medical services related to prescribing drugs for infertility. Please read the SelectHealth Member Handbook Infertility Services insert for more information.
Effective October 1, 2019, opioid analgesics prescribed to members of SelectHealth are subject to certain safety edits. Please read these SelectHealth Opioid Coverage Updates for more information.
General News and Notices
NYS FFS Medicaid will provide coverage for mosquito repellent when prescribed to enrollees who intend to travel to or return from a Centers of Disease Control (CDC) recognized area of localized Zika transmission. Read the Department of Health notice for more information.
The ICD-10 FAQ document is intended to provide a general overview of what can be expected with the transition from ICD-9 to ICD-10 as it impacts VNSNY CHOICE providers. Read the ICD-10 FAQ document.
Hypertension is one of the most important preventable contributors to disease and death in the United States, leading to myocardial infarction, stroke, and renal failure when it is not detected early and treated appropriately. The Eighth Joint National Committee (JNC8) recently released evidence-based recommendations on treatment thresholds, goals, and medications in the management of hypertension in adults. Read JNC8 Recommendations: Changes in Diagnosis and Treatment of Hypertension.
Provider Newsletters and Special Updates
- Reassure SelectHealth Patients Needing Screens and Tests This Fall About the Safety of In-Office Visits (October 1)
- Real-Time Prescription Benefits from CHOICE Partner MedImpact Going Live October 1 (September 28)
- CHOICE Total Provider Update: Using Telehealth for HEDIS Measures (September 22)
- An Important Change for Arranging Non-Emergency Medical Transportation for VNSNY CHOICE Members (August 18)
- SelectHealth Celebrates SCOTUS Ruling on LGBTQ Rights (June 16)
- Use of Telehealth Services During the COVID-19 Public Health Emergency for CHOICE Total Medicare Providers (May 14)
- Use of Telehealth During the COVID-19 State of Emergency (March 27)
- Emergency Pharmacy Guidance for Prescribers (March 20)
- Helping Your CHOICE Total Clients with Surveys This Spring: LHCSAs and for PCPs (March 17)
- Appeal a Claim vs. Dispute a Claim (March 13)
- Novel Coronavirus and People with HIV: a joint statement from the NYC Health Department and the NYS Department of Health (March 13)
- Preparedness for COVID-19 (March 10)
- Opioid safety edits were implemented January 1, 2019 (January 7)
- 2019 Provider Certifications (November 7, 2019)
- SelectHealth Expands to Westchester and Nassau Counties (October 27, 2019)
- Important Changes to Opioid Safety Edits for SelectHealth Providers (October 4, 2019)
VNSNY CHOICE Provider News – August 2020
In this issue:
- Enjoying Provider News? Take Our Reader Survey
- We Overhauled Our Provider Manual
- COVID-19 Information, All in One Place
- An Easy Way to Report Data
- We Simplified Communicating About Claims
- Encourage In-Office Visits When Needed
- We’re Surveying Our Members About Their Car
VNSNY CHOICE Provider News – January 2020
In this issue:
- Easily Inquire About a Claim
- Move to Electronic Payments
- Avoid Returned or Delayed Claims
- Bonus Tip: Include CPT II Codes on Bills
- CHOICE Total Member Survey This Spring
- HEDIS Medical Records Review Coming
VNSNY CHOICE Provider News – October 2019
In this issue:
- FIDA Demonstration ends on December 31
- Enhanced bonuses for viral suppression and a patient satisfaction survey at SelectHealth
- VNSNY CHOICE Total 2020 enrollment opens on October 15
- HHAeXchange could promote client safety in real time