Welcome, Brokers!

Fidelis Care would like to inform providers of a significant development impacting COVID-19 vaccine access across New York State. On Friday, Governor Kathy Hochul signed an executive order declaring a disaster emergency to ensure near-universal access to the latest COVID-19 vaccines. This order, effective through October 5, 2025, enables pharmacists to prescribe and administer the 2025–2026 COVID-19 vaccine formulations to patients ages 3 and older. While the FDA has only approved the latest vaccine formulations for individuals at high risk of severe illness or those aged 65 and older, the executive order allows broader access in anticipation of the upcoming respiratory virus season. Key Points

Fidelis Care is pleased to announce that a new Provider Bulletin is now available. The bulletin features updates on important initiatives and the latest news of interest to our provider community. Articles in this issue: ·         Championing Mental Health: Early Intervention is Key ·         Important Reminders About HIV Prevention and Testing ·         Supporting Maternal Health for Healthy Pregnancies and Babies ·         Encourage Preventive Cancer Screenings ·         Help Your Patients of All Ages Stay Active! ·         Access and Availability Standards   Please download Fidelis Care Provider Bulletin – Volume 11, Issue 3.   To view our Provider Bulletin Library, please visit: Provider Bulletins.

As part of an ongoing series, Fidelis Care will highlight some best practices we learn from our partners across the State in the interest of providing the best experience possible for our members. For this month’s highlight, we’re looking at the Teach-Back Method, a communication technique where providers ask patients to repeat back key information in their own words. This helps confirm understanding, identify confusion, and reinforce learning—especially around diagnoses, medications, and follow-up care.   How It Works After explaining a concept or instruction, you may want to say: “I want to make sure I explained this clearly. Can you tell me how you’ll manage

The following sections of the Fidelis Care authorization grids have been updated effective October 1, 2025.             The following code has been added to the Medicaid DME Authorization grid and requires prior authorization for Medicaid, Medicare, Essential Plan, and Metal-Level lines of business: L1907   Afo supramalleolar custom   The following code has been added on the Medicaid, Medicare, Essential Plan, and Metal-Level Products Authorization Grids and requires prior authorization: J9306 pertuzumab (Perjeta)   The following code has been added on the Medicaid, Essential Plan, and Metal-Level Products Authorization Grids and requires prior authorization: J9308 ramucirumab (Cyramza)   The following code has been added on the Medicaid and Metal-Level Products Authorization

Fidelis Care will host two Provider Office Hours in September 2025. 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 – September 2025 Topic: Quality Office Hours- Clinical Documentation Improvement When:  Wednesday, September 17th – 10AM – 11AM EST Click here to register*   Topic: Fidelis Care – Back to Basics When:  Thursday, September 18th – 9AM – 10AM EST Click here to register*