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Reminder: New York State Health Care Reform Act (HCRA) Surcharge Requirements
11/12/2026 • Posted by Provider Relations

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 Care's process includes member cost-share amounts when calculating and reporting applicable HCRA surcharge payments.

Providers are encouraged to review their billing processes to ensure that Fidelis Care members are not billed separately for these HCRA surcharge amounts.

For additional information about HCRA, please refer to the New York State HCRA Information available through the New York State Department of Health or the HCRA information included in the Fidelis Care Provider Manual.

Thank you for your continued partnership and for helping ensure accurate billing for Fidelis Care members.

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