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Fidelis Care would like to remind providers of requirements related to the New York State Health Care Reform Act (HCRA) surcharge. HCRA requires certain payors and providers of health care services to participate in funding mechanisms that support New York State health care initiatives. Fidelis Care is an elected payor under HCRA and pays the applicable surcharge on behalf of its plan participants directly to the New York State Public Goods Pool. Providers should not separately bill Fidelis Care members for HCRA surcharges that are the responsibility of Fidelis Care as the elected payor, including applicable surcharges associated with member cost-sharing. Fidelis

Fidelis Care is proud to support initiatives that expand awareness, reduce stigma, and improve access to resources for individuals affected by substance use disorders. Through our partnership with Shatterproof, we recently participated in two impactful efforts focused on education, advocacy, and community engagement.   Throughout October, employees and our provider partners united in support of Shatterproof and the movement to end addiction stigma, with participation spanning three areas of New York. Teams supported regional Walk Your Way events in Albany and Buffalo, along with the New York City Shatterproof Walk, bringing greater visibility to substance use disorder awareness across the state. Employees

Fidelis Care will host four Provider Office Hours in November 2026. During the webinars, Fidelis Care staff will be available to share information, provide an overview of provider resources, and answer your questions. Provider Office Hours – November 2026   Topic: Fidelis Care – Back to Basics When:  Thursday, November 5th – 9AM – 10AM EST Click here to register*   Topic: Timely Access to Care – Access and Availability Standards When:  Tuesday, November 10th – 2 PM – 3

The following sections of the Fidelis Care authorization grids have been updated.           The following section of the Medicaid, CHP, Essential Plan, Ambetter Metal-Level Plans, and Medicare Authorization Grids and requires prior authorization effective October 1, 2026: III.      Outpatient surgery: The following services require prior authorization:                    D.  Skin surgery and other dermatological procedures:          Only the following codes require authorization for any place of service: A2046, A2047, A2048, A2049, A2050, Q4207, Q4223, Q4243                              V.       Outpatient and DME Services: The following services require prior authorization:                    A.    Diagnostic testing:                          Proprietary Laboratory Analysis: 0666U, 0668U, 0669U, 0689U, 0692U, 0694U, 0698U         The following codes have been updated on the