The Fidelis Care Blog

As part of our ongoing work to improve the prior authorization (PA) process for both providers and members, Fidelis Care wants to share some important updates to our PA requirements for Medicaid, Ambetter From Fidelis Care and Medicare lines of business.

The following sections of the Fidelis Care authorization grids have been updated effective April 1, 2026.

Fidelis Care will host three Provider Office Hours in March 2026. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions.

In accordance with Chapter 645 of the Laws of 2005, the New York State (NYS) Medicaid program does not cover prescription or physician-administered drugs used for the treatment of sexual dysfunction (SD) or erectile dysfunction (ED).

Fidelis Care would like to remind our provider community of the required protocols for submitting corrected claims and to clarify how these differ from appeals. Following these guidelines helps ensure timely and accurate claims processing.