MSSNY Advocacy Halts New Fidelis Appeals Consent Rule
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It was recently brought to the attention of the Payment and Practice Division that Fidelis was planning to implement a new consent requirement for appeals starting June 1. In response, MSSNY raised the issue with the Department of Health (DOH), requesting clarification on whether such a requirement is necessary, as it would add yet another administrative burden and potentially delay patient care.
We are pleased to report that Fidelis has since provided the following update:
Important Update: Written Member Consent Requirement Postponed
5/14/2025 • Posted by Provider Relations
Earlier this month, Fidelis Care notified providers that, pursuant to the regulatory requirements defined in Article 44 of the New York State Public Health Law for all Managed Care Organizations, it was implementing a change to its appeals process by requiring the submission of written member consent. The change was scheduled to become effective on June 1, 2025.
NYSDOH has informed Fidelis that it is currently reviewing the policy and advised Fidelis Care to postpone its implementation. Therefore, Fidelis Care is rescinding the policy implementation until further notice and will provide an update when more information is available.
For additional questions or if we can assist in any way, please contact your Fidelis Care Provider Engagement Account Manager. To find your designated representative, please visit Contact Your Designated Provider Relations Specialist
