MedicaidPrior AuthMedium impact
2020 Q3 MHNY Provider Newsletter
Molina Healthcare·NY·Provider Newsletter
Effective date
Oct 1, 2020
We identified it
Jun 19, 2026
Summary
Molina Healthcare of New York implemented several policy changes including new pre-payment edits for drug and biological codes effective 11/24/20, elimination of prior authorization requirements for Home Health Care Services from licensed agencies effective 10/1/20, and introduction of COVID-approved codes effective 10/20.
Action Required
By November 24, 2020: Billing team must prepare for new pre-payment edits on drug and biological codes - review current drug/biological billing practices and ensure proper documentation. Immediately: Stop requiring prior authorizations for Home Health Care Services from licensed Home Care Agencies for Molina NY members. Update authorization workflows and notify relevant staff. For COVID-approved codes: Verify with Molina for current published rates before billing.