June 11, 2021

This morning a member agency rep passed along a concern that a fellow BH provider had shared with her regarding a notice they had received from Fidelis stating that ‘effective 6/16 all Telehealth services would require preauthorization for all Lines of Business.’  We immediately contacted OMH Division of Managed Care (Joe Katagiri, Acting Director).  OMH immediately contacted Fidelis to ‘clarify’.  A moment ago, I learned that Fidelis will NOT be implementing this bogus requirement.

We have received numerous calls from members sharing concerns regarding notices / policy changes that are unenforceable based on current laws, policies, guidance or waivers. Interestingly, the frequency of these complaints has increased during the COVID-19 pandemic.  I view this as an insurer preying on a provider who may be vulnerable to these tactics during a time of great stress. 

We continue to bring examples of this behavior to the attention of DFS and DOH leads, as well as to the state agencies.  When it happens we encourage you to consider filing a complaint with OMH and OASAS or DFS.

If you have any doubt as to the validity of a directive or policy change announced by an insurer, call me and I will check it out.  I know you join me in thanking Joe Katagiri and the team at OMH for acting so quickly on our behalf.