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Horizon BCBS NJCommercial · Administrative · Quality MeasuresMedium impact

Now Live: 2026 FEP Provider Quality Incentive Program

Act
by May 1, 2026
Effective date
May 1, 2026
Identified
Oct 3, 2026

Summary

FEP Blue launched a 2026 Provider Quality Incentive Program (May 1–December 31, 2026) that rewards practices for closing HEDIS care gaps in preventive and chronic care services. Billing teams must monitor monthly gap reports on HorizonDocs Outreach, coordinate patient outreach, and submit claims or supplemental data to earn incentives tied to completed care activities.

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What to do

by May 1, 2026 · 6 steps
01Billing team and clinical staff must establish access to HorizonDocs Outreach portal to review monthly HEDIS care gap reports.
02Coordinate with providers and clinical staff to identify patients with open care gaps for preventive and chronic care services.
03Implement patient outreach workflow to schedule needed services.
04Ensure claims are submitted accurately or that approved supplemental data is provided to receive incentive credit for completed activities.
05Track closed care gaps and incentive earnings by measure.
06Contact FEP Provider Services (FEHB: 1-800-624-5078 or PSHB: 1-888-222-7175) for technical support with the portal or incentive structure.
If missed: Failure to submit claims or supplemental data will result in missed incentive opportunities.

Original notice

Now Live: 2026 FEP Provider Quality Incentive Program
horizonblue.com · Always check the source before changing claims.
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Related changes

See all Horizon BCBS NJ changes →
2025 Federal Employee Program (FEP) Provider Quality Incentive ProgramMediumEffective Jun 1, 2025 · Quality MeasuresClose Care Gaps for FEP Members and Earn IncentivesMediumNo effective date · Medicare2024 FEP Provider Quality Incentive Program to Close Gaps in CareMediumEffective Sep 19, 2024 · Quality MeasuresBrowse every Horizon BCBS NJ change in the policy list

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