The Fidelis Care Blog

Fidelis Care is committed to ensuring accurate claims processing and compliance with state and federal requirements. Providers who identify an overpayment may self‑disclose and refund the amount owed by submitting a refund check along with the required documentation.

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).