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02/17/2026

Priority Health Update

Priority Health Managed Care Committee Member

Flora Varga

Flora Werle - The Cancer & Hematology Centers


Priority Health Provider Recent News HERE


We’re extending telehealth flexibilities for our Medicare Advantage plans through Dec. 31, 2027

Congress recently extended the Original Medicare telehealth flexibilities through Dec. 31, 2027. Following CMS’s guidance, we’ll also extend those flexibilities for our Medicare Advantage (MA) plans through Dec. 31, 2027, for services provided by in-network providers. 

These flexibilities loosen geographic and location restrictions on where services could be provided and loosen limitations on the scope of practitioners who can provide telehealth services. 

We’ll soon process claims for telehealth visits with our MA members submitted on or after Feb. 1, 2026, for appropriate payment. 


Mark your calendars: New Priority Health provider portal signup begins this summer

To best serve you and your patients, today and in the future, we’re making changes to our online platforms and some processes. These changes, which include a new provider portal, will take effect on August 1 of this year READ MORE


Upcoming Medical and Pharmacy Drug Changes

To support drug access and affordability for our members, we’re making some changes to our medical and pharmacy drug coverage READ MORE 


2026 HIDE-SNP and D-SNP Model of Care training is now available and required for Medicare and Medicaid providers

Providers play an integral role in the care teams that support our special needs plans (SNPs) members. That's why the Centers for Medicare and Medicaid Services (CMS) requires us to make sure providers who are contracted with us to see Medicare or Medicaid members are trained on our Model of Care (MOC) every year. READ MORE


We’ve Made Changes to our Claim Appeals Process

We’ve made some changes to our claim disputes process to streamline options for you and align with industry best practices. We’ve also made changes to the requirements for escalating claims READ MORE


Check Out our New Provider Education Videos - VIEW HERE

 

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