Better Care, Better Practices
CAIPA Connection
Quality Updates
Registration is Open for the 2026 Quality Event on July 8
View the details around this important event created to help providers maximize key quality measures that can directly impact care outcomes.
Healthfirst
New incentivized measures have been released for identified members in the denominator who are most at risk for medication non-adherence. View the new target cutoffs!
VNS Choice
Learn about Let’s Get Checked, VNS Health’s partner for at home screenings that can help close HEDIS care gaps. Learn more.
Health Plan Updates
MetroPlus NDC Billing Requirements for Claims Processing
MetroPlusHealth has announced July 2026 updates, including new NDC billing requirements for physician-administered drugs effective July 1, 2026, and prior authorization changes for selected services effective July 15, 2026.
EmblemHealth: SOMOS Network Termination
SOMOS will no longer participate in the EmblemHealth network effective July 1, 2026, with related updates to care management, claims, and member transition guidance.
DentaQuest & Liberty Dental
A reminder of the health plans administered through DentaQuest and Liberty Dental.
Oscar Health Prior Authorizations Moving to Availity
Starting June 15, 2026, Oscar will move all prior authorization functions from its Provider Portal to Availity Essentials.
Preventive Visit Billing Policy Reminder
Many health plans are actively enforcing updated reimbursement policies related to billing preventive visits with additional E/M services.
Electronic Funds Transfer (EFT) Enrollment
CAIPA recommends that providers enroll in EFT and ERA to help avoid payment and check-related issues.
SNP Model of Care (MOC) and Cultural Competency Training
A reminder for providers to complete the 2026 SNP Model of Care (MOC) and Cultural Competency training, including the required attestations.
Upcoming Event
Register for the MAMES 20th Annual Scientific Meeting
CAIPA providers are invited to the 20th Annual Scientific Meeting by the Myanmar American Medical Education Society, a CME conference, for a day of education, collaboration, and professional development.
MSO Updates
MSO Updates
CAIPA is proud to engage our membership and the communities we serve! See where we were throughout June 2026, including the start of our 2026 Quality Event series!
