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Access to quality care is important to eliminate health disparities and increase the quality and years of healthy life for all New Yorkers. The NYSDOH requires that certain Access and Availability Standards be met by PCPs, OB/GYNs, specialists, and behavioral health providers where applicable. Click here to view the full list of standards, including situations and timeframes.   For additional questions, or if we can be of assistance in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please click here. 

Fidelis Care has been made aware of an issue affecting providers who are unable to obtain authorizations through the Evolent/RadMD portal due to their NPI or TIN not appearing in the system. The issue has been identified and escalated as a priority for resolution. What to Do: If you are unable to obtain authorizations through the Evolent/RadMD website, please contact the Evolent Call Center: Fidelis Care (NY) – Medicaid or Exchange: 1-800-424-4952 Fidelis Care (NY) – Medicare: 1-800-424-5390   We anticipate this issue will be resolved by early next week. Once it is addressed, we will share an update. If you have any additional questions, please

Fidelis Care would like to inform our providers of plan changes that will be effective January 1, 2026.    Wellcare By Fidelis Care Wellcare Fidelis Dual Plus (HMO D-SNP) – Plan 003 Effective January 1, 2026, the plan name will change from Wellcare Fidelis Dual Plus (HMO D-SNP) to Wellcare Fidelis Dual Align (HMO D-SNP). Wellcare Fidelis Dual Access (HMO D-SNP)

Fidelis Care is initiating a transition process for providers to identify members who are currently receiving group and family therapy services, and who will continue treatment beyond November 1, 2025, along with current frequency and duration. The below FAQ was created to address provider questions related to the updated authorization requirements, which are in effect for dates of service of November 1, 2025, and thereafter. Providers should submit their member rosters to qhcmbh@fideliscare.org using format outlined below, no later than October 31, 2025. This information will ensure a smooth transition for members engaged in treatment.   As a reminder: Effective November 1, 2025, the

Fidelis Care would like to remind providers of New York State Medicaid reimbursement policy for x-ray examinations performed during the same visit.  This policy applies to the following lines of business: Medicaid CHP Essential Plan Ambetter from Fidelis Care Per NYS guidance: Multiple X-rays during the same visit: Reimbursement will be limited to the greater fee, plus 60% of the lesser fee(s). For more information, please reference the eMedNY New York State Medicaid Provider Procedure Code Manual. If you have any additional questions, or if we can be of assistance in any way, please contact your Fidelis Care

Fidelis Care is committed to supporting continued access to telehealth services. Although Congress only authorized Medicare reimbursement for expanded telehealth services through September 30, 2025, Wellcare By Fidelis Care will extend coverage for Medicare telehealth benefits through 2026.   There will be no disruption in coverage to our Wellcare By Fidelis Care members or providers during 2025 and 2026. Providers should continue to offer and bill for telehealth visits as they normally would.   Wellcare By Fidelis Care’s Medicare plans have benefits aligned with the flexibilities that have been previously offered as supplemental benefits. As a result, even after the expiration of Medicare flexibilities,