Supporting Your Patients Through New York’s Social Care Networks • As part of the CMS-approved $7.5 billion New York 1115 Medicaid Waiver Amendment, Social Care Networks (SCNs) are now active across all regions of the state, connecting Medicaid members with critical services that address health-related social needs. • Services are funded through March 31, 2027, and there is a statewide goal of screening 100% of eligible Medicaid members by the end of the demonstration period. • Nine regional SCN Lead Entities coordinate a contracted network of community-based organizations and social care service providers to screen members and deliver services — including food assistance, housing support, transportation, education, and employment resources. • Research continues to show that addressing these social determinants leads to improved health outcomes and reduced cost of care, making this program a vital complement to the clinical care you provide. • You can inform patients about the availability of SCN services, share contact information for the SCN in their residential county, and — when requested — provide a Provider Attestation to support a patient’s eligibility for enhanced services. • Providers also have the option to contract directly with an SCN Lead Entity to receive reimbursement for screening and service navigation. Whether or not you choose to formally join an SCN, sharing screenings is strongly encouraged by the Department of Health to support program goals. For more information — including a county look-up tool to identify your patients’ regional SCN — visit fdeliscare.org/SCN or contact your regional SCN Lead Entity directly. Access & Availability Standards: What to Know New York State Department of Health access and availability standards help ensure members receive timely care across Primary Care, Behavioral Health, OB/GYN, and Oncology. Common compliance challenges, such as inaccurate provider information, appointment delays due to paperwork, or limited after hours access, can create barriers to care. Providers and ofce staf play a critical role in improving access and supporting a better member experience. Why Your Compliance Matters Compliance with access and availability standards is essential for delivering timely, quality care. Together, we ensure members get the right care, at the right time, in the right setting. Quick Solutions & Reminders • Always verify provider status and plan participation before telling a patient “no.” If unsure, ofer to call them back with accurate info. • Don’t let paperwork or referrals delay care. Schedule the appointment frst, then guide the patient through what’s needed before the visit. • Patients with a scheduled appointment should not be kept waiting more than one hour. • Patient calls must be returned within 30 minutes. • Providers may meet the appointment wait time standards through telehealth services, unless the patient specifcally requests an in-person appointment.
Spring 2026 Fidelis Care Provider Bulletin
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