February 9, 2023
2023 Health Partners Medicaid Benefit Update: $0 Copays
In an effort to reduce barriers to care for our Medicaid population, effective January 1, 2023, Heath Partners Plans has adopted a $0 copay for all medical benefits for our Health Partners (Medicaid) health plan. We believe that greater access and lower out-of-pocket costs for the member will lead to improved health outcomes.
HPP has updated its claim’s processing system to reflect these changes and will be reprocessing claims for dates of service on or after January 1, 2023 to ensure our network is reimbursed for copays applied to these benefits. We have identified the claims impacted and are in the process of reprocessing them, which should result in additional payment to you for services rendered.
To help you identify whether the service you provide are impacted by this change, please reference the table below.
|
Benefit/Service |
2022 Copay |
2023 Copay |
|
Advanced Diagnostic Radiology (MRI, CT, PET) |
$1 |
$0 |
|
Ambulatory Surgery Center/ Short Procedure Unit |
$3 |
$0 |
|
Chiropractic Services |
$1 |
$0 |
|
Diagnostic Radiology (X-ray) |
$1 |
$0 |
|
Elective Inpatient Surgical Care |
$3 per day up to $21 per admission |
$0 per day |
|
Inpatient Acute Hospital |
$3 per day up to $21 per admission |
$0 per day |
|
Inpatient Rehab Hospital |
$3 per day up to $21 per admission |
$0 per day |
|
Medical Diagnostics |
$1 |
$0 |
|
Nuclear Medicine |
$1 |
$0 |
|
Pharmaceutical |
$1 generic and $3 brand |
$0 for covered drugs |
|
Sleep Studies |
$1 |
$0 |
|
Stress Echocardiography, Echocardiography & Cardiac Nuclear Medicine Imaging |
$1 |
$0 |
|
Ultrasound (US) |
$1 |
$0 |
If you have any questions about this change, please contact the Provider Services Helpline at 1-888-991-9023 (Monday–Friday, 8:30 a.m. to 4:30 p.m.).
As always, we thank you for your continued efforts to improve the health of our members.