MedicaidAdministrativeMedium impact
Reminder: No Referrals for EmblemHealth’s State Sponsored Programs and Essential Plans
EmblemHealth·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth has eliminated the requirement for primary care provider (PCP) referrals for specialty care visits for members enrolled in Enhanced Care (Medicaid), Enhanced Care Plus (HARP), Child Health Plus, and Essential Plan programs. This means specialty providers can now see these patients without obtaining referrals first.
Action Required
Immediately: Front desk staff should update verification procedures to no longer require referrals for EmblemHealth Enhanced Care (Medicaid), Enhanced Care Plus (HARP), Child Health Plus, and Essential Plan members before scheduling specialty appointments. Update scheduling protocols and train staff on the new member ID cards that reflect this change.