Molinalogo

 Guidelines Update In-Home Sleep Studies for Obstructive Sleep Apnea (OSA) Diagnosis

 Changes to Prior Authorization Requirements Effective: 3/1/25

 Availity Appeals and Reconsideration Changes      

 Availity Update: Prior Authorization Requirements Effective: 3/1/2025

 Continuing Medical Education Credits, Sign Up for February 25, 2025

 Q4 2024 Provider Newsletter

 Unblocking Molina Healthcare Fax Numbers for UM Communications

 Effective 11.19.24 Provider Office Laboratory Testing (POLT) - Additional Codes Added


 Providers' Member Rewards Incentive Flyer
 Managing Claims in Availity (Appeals, Reconsideration Inquiries, and Corrected Claims)     
 Availity Update: Prior Authorization Application Update Effective 12/9/2024
 Changes to Prior Authorization Requirements Effective:1/1/2025
 Q3 2024 Provider Newsletter
 Trauma-Informed Care for Children/Youth in Foster Care
 Claims for Genetic Testing Services During Pregnancy
 OASAS Change Opioid Treatment Program
 TMS Provider Benefit Notification Form
 Q2 2024 Provider Newsletter
 NYS Medicaid ID Rules (April 2024)
 Quality Commercial Health Overview (May 2024)
 MCG 28th Edition Goes Live (April 16, 2024)
 Optum-Change Healthcare Outage Update (April 5, 2024)
 SBMH Clinic Rate Enhancement, Timely Filing
 Q1 2024 Provider Newsletter
 Children's HCBS Authorization and Care Manager Notification Form
 Optum-Change Healthcare Outage update (March 18, 2024)
 Effective April 1 2024 Essential Plan 200 250 Provider Notification
 2/29/24: Optum-Change Healthcare Outage Update
 2/26/24: Optum-Change Healthcare Outage
 FAQ- Optum Pause & Pay Program
 Effective March 1, 2024: Services in link are allowed in all Network Physician’s Office Setting
 March 2024 Quality Commercial
 February 2024 Quality Commercial
 January 2024 Quality Commercial
 Submit and Track Your Appeals on Availity Essentials
 Provision and Coordination of Services for Children/Youth in Foster Care
 Important Information from the Quality Department: Quality Commercials:

           October 2023
           November 2023
           December 2023

 2/1/24: Molina General Provider Notice of Healthmap
 2/1/24: EDSD Guidance for Providers
 2/1/24: Provider Newsletter Q4 2023
 1/1/24: Child Health PLUS Expanded Benefits to include Home and Community Based Services (HCBS)
 11/28/23: Enhancement to Reporting of Refunds on EOPs
 9/11/23: Provider Newsletter Q3 2023 
 9/1/23: Effective 9/1/23 - Claims submitted with missing, invalid, and incomplete NDC Information will be denied
 8/21/23: Medicaid PDMP Reminder
 8/18/23: Reminder: There is a Prior Auth LookUp Tool for J Codes or other HCPCS codes for medications
 7/26/23: Reminder: Molina has a LookUp Tool for J Codes and other HCPCS codes for medications on our website 
 7/1/23: Effective 7/1/23: Changes to Prior Authorization Requirements
 6/1/23: Provider Newsletter - Q2 2023
 5/1/23: Effective 5/1/23: Fax Size Limitation for Clinical Information
 4/1/23: Effective 4/1/23: Addition of Residential Rehabilitation Services for Youth (RRSY) Benefit for CHP (Grid)
 3/1/23: Provider Newsletter - Q1 2023
 3/1/23: Effective 3/1/23: Changes to Prior Authorization Requirements                    
 1/1/23: Effective 1/1/23 – Grid of Benefit Changes for all Lines of Business
 1/1/23: Provider Net Sunsetting Notice
 1/1/23: Effective 1/1/23 – Molina will no longer accept claims submitted via non-approved submission pathways
 12/22: Implementation of new payment platform through ECHO Health complete
 10/1/22: Effective 11/1/22: Change to PA Requirements for PT/OT/ST
 10/1/22: Effective 11/1/22: Change to PA Requirements for Home Care 
 6/1/22: Pharmacy Real-Time Prescription Benefits Tool Now Available
 RTB Information at Point of Care Document
 Real-Time Prescription Benefits Access and Onboarding Handbook
 5/25/22: New MCG AutoAuth Process– Advanced Imaging
 Availity Portal Instructions
 Legacy Portal Instructions 
 2/1/22: Adult BH HCBS transition to CORE
 1/24/22: Additional Provider Education - Services Provided to Children/Youth in Foster Care
 1/1/22: Beacon Health Benefits End for Downstate Affinity by Molina Healthcare Members
 Provider FAQs - Beacon Transition 
 General Provider Notice - Beacon Transition
 11/1/21: Molina Healthcare of New York, Inc. will partner with Progeny Health, LLC
 10/1/21: Applied Behavioral Analysis Benefit (ABA) - Changes in Prior Auth Codes
 9/1/21: Prior Auths will transition back to Molina (away from eviCore)
 4/1/21: Molina Partners with Locus Calocus
 4/1/21: Q2 Prior Auth Updates
 4/12/21: Removal of Knee Replacement Procedure Code
 3/1/21: Molina Partners with MCG Health

Provider Newsletters Archive

 Q4 2022 Provider Newsletter
 Q3 2022 Provider Newsletter
 Q2 2022 NCQA Provider Newsletter
 Q1 2022 Provider Newsletter

 Q4 2021 Provider Newsletter
 Q3 2021 Provider Newsletter
 Q2 2021 NCQA Provider Newsletter
 Q1 2021 Provider Newsletter 

 2020 Q4 MHNY Provider Newsletter
 2020 Q3 MHNY Provider Newsletter
 2020 Q2 NCQA Provider Newsletter
 2020 Q1 Provider Newsletter

 2019 Q4 Provider Newsletter
 2019 Q2 NCQA Provider Newsletter
 2019 Q1 Provider Newsletter

Provider Communications Archive

 Crisis Residence Services - Effective 12/1/20
 COVID Payment Policy (when rates are unavailable)
 Mock HEDIS Audit - 10/5-12/11
 New Drug and Biological Pre-Payment Code Edits - Effective 11/24/20
 Reduction in PA Codes - Home Health Services - Effective 10/1/20 * CDC Guidelines
 Molina itemized billing effective 7/15
 New Prepayment Claims Review beginning 6/30/20
 Patient Cost-Sharing for Laboratory Tests to Diagnose COVID-19
 Coronavirus: Utilization Review and Emergency Admission Notification
 New Prepayment Claims Review
 COVID-19 Telehealth Billing
 Coronavirus Provider FAQ
 eviCore New Prior Authorization Requirements Effective 4/1/20
 Coronavirus Talking Points for Providers
 Pre Pay Audit Provider Notification Letter
 Pharmacy Network Changes Effective 1/1/20
 eviCore Update
 eviCore HOLD Notification
 New Prior Authorization Requirements through eviCore Mobile Health Spot
 Member Incentive Program
 New Prior Authorization Requirements through eviCore
 Changes to Prior Authorization Requirements effective 10/01/2019
 Prior Authorization Update_SPA Services
 Provider Update: Review of Sepsis and Septic Shock

Provider Bulletin Archive

 Provider Bulletin- NICU Payment Review Policy 
 Provider Bulletin- MHNY Provider Letter Fertility Benefits
 Provider Bulletin- MHNY Provider letter Children's Carve In
 Provider Bulletin- June 2019: New Appeal Request Form

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