As your health care partner, Fidelis Care is notifying you about key changes to how we will manage our members’ benefits for family planning and reproductive health services. These changes will take place on January 1, 2019.
Fidelis Care has made changes to our Medicaid Managed Care, Child Health Plus, and HealthierLife Formulary effective in the 4th quarter 2018. Some of the changes relate to quantity limitations, authorization requirements, as well as drugs being removed and added to the formulary. To review the list and the effective dates, download formulary changes.
Effective December 1, 2018, Fidelis Care is making changes to Medicaid and Child Health Plus vaccine codes regarding age limitations and removal of the authorization requirement.
For outpatient place of service (physician or facility claims), please note the following changes:
Fidelis Care is pleased to inform you that the most recent 2018 QARR Non-Compliance Report has been posted on Provider Access Online (Fidelis’ Provider Portal). This information is indicative of all encounter data on file with Fidelis Care as of 9/17/2018.
Each year, Fidelis Care reviews our Medicare Advantage products and benefits, with a goal of offering the most competitive plans possible for members.
Balancing rising health care costs, providing key benefits important to members, and continuing to serve low-income seniors are the priorities around which our Medicare Advantage plans and benefits are determined for the coming year.
For 2019, Fidelis Care will continue to offer Medicare Dual Advantage plans in the four regions (New York City, Albany, Buffalo, and Syracuse) where we are currently operational. These plans are for those who are eligible for Medicare and Medicaid (dual-eligible beneficiaries).