WellCare New York members enrolled in Medicaid, Child Health Plus, and Essential Plans products* will transition to and become Fidelis Care members effective June 1, 2020.
For members enrolled in a WellCare Medicaid, Child Health Plus, Managed Long Term Care, or an Essential Plan product, prior Authorizations issued by WellCare for dates of service on or after 6/1/2020, will transfer with the member’s eligibility, effective 6/1/2020, to Fidelis Care.
Pharmacy Medication Guidance
•Medicaid covers a 90-day supply for most prescription and over the counter (OTC) maintenance medications
Please note, prior authorization may be required for 90-day supplies of some medications.
COVID-19 UPDATE: Please refer to this link: Important Updates Regarding Coronavirus COVID-19, for authorization and coding guidelines related to the COVID-19 Pandemic.
The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2020.
Fidelis Care is pleased to inform you that the medical record second request letter and details for 2020 HEDIS/QARR have been posted on our Provider Portal, Provider Access Online (PAO). Please review these materials and send the requested documentation to Fidelis Care as soon as possible.