As trusted Provider Partners, MVP wants to share exciting information and updates to help support our collective goal of building better communities.

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Summertime Reminders
Published July 2024
August is immunization awareness month, and summer is a great time for parents to review their children’s vaccination checklist and prepare for the oncoming schoolyear. Read More
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Let’s Talk About HPV Vaccination and Cancer Prevention
Published July 2024
The Human Papillomavirus infection affects about 85% of the US population and can cause six types of cancer. Learn more about how you can educate parents and caregivers about the importance of getting their children vaccinated.
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2024 Provider Practice Satisfaction Survey – Last Call!
Published July 2024
MVP invites you to offer feedback that will help us continue to improve your experience while doing business with us. Read More
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Tips for Documenting Major Depressive Disorder
Published July 2024
Major Depressive Disorder, also known as clinical depression, is one of the most common mental health conditions and can affect anyone. Please review tips for identifying and documenting MDD. Read More
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MVP Living Well Programs For Your Patients
Published July 2024
MVP offers free virtual and in-person opportunities to support your patient’s overall well-being. Read More about classes coming soon that they may be interested in taking part.
DualAccess Cost Share and Training Update
Published April 2024
If you care for MVP Medicaid and Medicare Members, please review the MVP policy regarding collecting cost-share from MVP DualAccess Members. Read More 
Encourage Members to Complete an ADI
Published April 2024
Learn how encouraging MVP Members to complete an Authorization to Disclose Information (ADI) form can improve their coordination of care between their Providers. Read More  
Important Reminders for Behavioral Health Facilities
Published April 2024
Important information our Behavioral Health Facility partners should know when caring for MVP Members. Read More 
2024 Provider Practice Satisfaction Survey
Published April 2024
Be on the lookout for the 2024 MVP Provider Satisfaction Survey! Read More
New York State Medicaid Pharmacy Benefits
Published April 2024
Based on feedback we’ve received, Members are not aware their pharmacy benefits are now administered through NYRx. Please read how you can help remind your patients of this change. Read More

Reporting Overpayments
Published April 2024
Participating Providers and subcontractors are required to report, return, and explain overpayments within 60 days of identification. Find out more about how to report overpayments to MVP. Read More

Protocols for Domestic Violence Victims and Endangered Individuals
Published February 2024
Review information on confidentiality protocols for domestic violence victims and endangered individuals. Read More 
MVP Code of Ethics and Business Conduct Summary
Published February 2024
Review MVP’s Code of Ethics summary that impacts our Providers, Vendors and Contractors. Read More 
Member Surveys
Published February 2024
Please remind your patients to review and return surveys they will be receiving related to their overall satisfaction with their health care. Read More 
  • Making a Difference
    Published October 2023

    Providers from Mohawk Valley Medical Associates (MVMA) IPA share some innovative programs that have had a positive impact on their patients.

    In 2020, MVMA launched Program Innovation and Excellence. Can you elaborate on the goals of this initiative?

    This program was designed to reward our Independent Practice Association (IPA) participating physicians that have identified areas of improvement in their practice that will positively impact the patient experience, improve patient health, and increase patient satisfaction. Each program must have measurable goals, and reporting must be a component that illustrates the progress throughout.

    Can you provide examples of programs that have been implemented and what successes have been achieved?

    Inflammatory Bowel Disease (IBD) Qorus Program

    Saratoga Schenectady Gastroenterology Associates

    This program has been in place for six years and has consistently demonstrated high quality of care for inflammatory bowel disease patients. These patients have special access to the practice with dedicated staff that ensures prompt disease management. An integral part of the success of this program is due to the efforts of two IBD Nurse Care Coordinators and an IBD Nurse Practitioner. This has resulted in improved disease control, thereby reducing complications, ER visits, hospitalizations, and opiate usage. The program is aligned with the IBD Qorus initiative (a national quality improvement program of the Crohn’s and Colitis Foundation) which has created a database so we can track quality measures, outcomes, and improvements.

    Osteoporosis Management Program

    Capital Region Orthopedic Associates and Albany Medical Center Endocrinology

    This program has been in place for just over one year and is already showing great promise for improved management of osteoporosis following an initial fracture. The goal is to prevent a second fracture through an individualized treatment regimen in collaboration with Albany Medical Center Endocrinology. Male and female patients with fragility fractures are identified and seen by an in-house Advanced Practitioner as well as an Endocrinologist. These patients undergo testing for osteoporosis as well as underlying disease etiologies and a high percentage are started on antiresorptive therapy. The program is aligned with the “Own the Bone” registry sponsored by the American Orthopedic Association, a national systems-based multidisciplinary fragility fracture prevention initiative.

    Opioid Management Program

    Saratoga Regional Medical Group

    This program began in 2019. Since that time, over 1100 managed patients have improved in every measure including the reduction of average opioid dose and tapering off opioids completely. Many are willing to be actively followed by the comprehensive pain management team. The team consists of two pain management clinical pharmacists and a substance abuse counselor, who have integrated into the primary care setting, and work directly with primary care providers and staff to improve several opioid parameters revolved around opioid risk mitigation and utilization overall.

    Specifically, these positions are embedded in Primary Care clinics throughout Saratoga Medical Group for referral from primary care providers to allow for pain management via face-to-face and telehealth consultation in patients prescribed long-term opioid therapy. Additional services include E-consultation reviews, core pain management activities and curbside consults, as well as administrative functions such as population management.

    The program has expanded to include inpatient consultations prior to discharge for both substance abuse and chronic pain patients. In response to historic increases in behavioral health needs and engagement since the COVID-19 pandemic, the team has undergone extensive cross training for psychiatric medication management, especially for managing anxiety and depression. Provider feedback has been tremendous thus far, and pharmacy residents have joined the team for training.

    Penicillin Allergy Identification Program

    Certified Allergy & Asthma Consultants

    This group collaborated with a nationally renowned practice in Connecticut to develop this program that has been in place for four years. The group has successfully tested over 600 patients, both established and referred from outside the group specifically for a history of penicillin allergy, with a 4% positivity rate. This has allowed many patients to be de-labelled as penicillin allergic and thereby avoid more risky and expensive alternatives. The program is being expanded to primary care providers and surgeons in the community and the group is now coordinating pre-surgery evaluation, to guide in antibiotic choice, with pre-admission testing departments for appropriate candidates. This is especially important to identify true penicillin allergy for total joint replacements.

    We thank the contributors of this discussion for sharing their innovative solutions for the continued health of their patients:

    • Richard B. Toll, MD, MVMA President & CEO
    • Robert Halbig, MD, MVMA Medical Director
    • Arthur Ostrov, MD, Co-Director of IBD Center, President Emeritus, Saratoga Schenectady Gastroenterology Associates
    • Cory Czajka, MD, Orthopedic Trauma, Capital Region Orthopedics
    • Jeffrey J. Bettinger, PharmD, Pain Management Clinical Pharmacist, Saratoga Hospital Medical Group
    • Dee Adkins, Executive Director, Certified Allergy & Asthma Consultants
    • Debbie Zadrozny, RN, MVMA Executive Director

    About MVMA

    Mohawk Valley Medical Associates (MVMA) IPA and was founded in Schenectady, New York in 1983 by a small group of community-minded physicians. The goal was to lay the groundwork for a local, Schenectady-based HMO in response to market pressures both in the Capital District and beyond. MVMA has grown to over 3200 physicians in 9 counties that include the Capital District and surrounding counties in New York State.

  • Project TEACH Supports PCPs
    Published October 2023

    Over the past several years, Providers have had to overcome the challenges presented by COVID-19, as well as environmental events that have impacted us all.Children and young mothers are often among the most vulnerable to these life-changing events, both physically, but equally as important, mentally.

    MVP reminds Pediatric and Maternal Health Providers that there are resources available that may help to bridge any gap in the emotional well-being of your patients.

    Project TEACH, a program funded by the NYS Office of Mental Health, aims to strengthen, and support Providers in delivering care to children, adolescents, and young adults up to 22 years of age who experience mild-to-moderate mental health concerns, including anxiety, depression, and ADHD. Project TEACH offers consultation, referrals, and CME training at no cost to NYS pediatric Primary Care clinicians.

    Maternal depression and related mood and anxiety disorders are prevalent and have serious impacts on parents and their babies. Addressing these conditions early leads to better health outcomes for mothers and children.

    To find out more about the consultation services and educational resources, visit

  • OnTrackNY
    Published October 2023

    OnTrackNY is a mental health treatment program for adolescents and young adults that specializes in early psychosis to help them achieve their goals for school, work, and relationships. There are currently no wait lists for referrals. For more information, visit

  • Human-I-T and MVP
    Published October 2023

    Bridging the digital divide 

    MVP understands some Members may face barriers accessing digital tools. Our goal is to support those Members with available resources, including the federal Affordable Connectivity Program (ACP), in support of their health journey. That’s why MVP has been strategically referring eligible Members to Human-I-T, a third-party organization to bridge the digital divide with step-by step support to enhance access to virtual health care services.

    Through this referral opportunity, Human-I-T links eligible Members with the Affordable Connectivity Program (ACP) to receive federal funding which provides:

    • Low-cost internet that will vary by Member. Actual rates and eligibility terms will be answered by Human-I-T
    • One time discount of $100 towards a qualifying digital device. These devices include reduced cost Chromebooks, which have the capability to support MVP apps

    If your patients receive government benefits, they may be eligible and will need to provide documentation and proof of these benefits. To learn more, contact Human-I-T by calling 1-888-391-7249 or visit

  • The Closers
    Published July 2023


    Providers from Saratoga Hospital and Open Door Family Medical Center shared challenges in closing gaps in care in the pandemic/post-pandemic world and some creative strategies to help overcome them.


    What have you learned over the last year that might be helpful to your colleagues when dealing with closing gaps in care for their patients?

    At Open Door, our clinicians stress preventive care at every visit, regardless of the visit reason, to take advantage of each opportunity to discuss immunizations, required screenings, or other services that the patient may need. There is also an organizational expectation that preventive care is discussed during a visit, and this is evaluated during the clinician peer review process. Each of our sites conducts quarterly staff meetings which include a review of quality measures and scores so there is heightened clinician awareness on the importance of gap closure. Open Door has expanded the role of team-based care compared to last year due to the Dramatic Performance Improvement project with Coleman Associates, which promotes a team approach to caring for patients.

    Saratoga Hospital has expanded the dietitian's role to provide Annual Wellness Visits, Intensive Behavior Therapy for weight loss, diabetic retinopathy screening, as well as other screening appointments and functions. Our registered dietitian is a valued part of the team and is collaborative, pitching in to help wherever needed. This approach helps to support the practice's model of preventive care. It is equally important that the care team has routine case conference meetings to discuss complex cases, barriers to care, and quality metrics. This supports closing gaps in care in a timely manner and reinforces with all staff the need to address the barriers to care that our patients may experience. These creative solutions have served as the "launching pad" for program development supporting our patients' disease management goals.


    Since many people have recently delayed preventive care, how have you overcome the obstacles and stay connected with your patients?

    Open Door used CareMessage, a text messaging platform, to contact patients that had gaps in care. For example, during the summer of 2022, Open Door texted adolescents that had not had a well visit in the calendar year. We asked them to schedule an appointment prior to the upcoming school year and offered backpack incentives to get them in.

    We also utilize “Patient Visit Planning Reports” to address care gaps for patients that come into the health center for an appointment. Over the past year, we have prioritized the need for morning huddles between the clinicians and their support staff to review gaps in care and plans for addressing them at the time of the patient visit.

    One of the strategies we had at Saratoga Hospital was to convert our Nutritional Services to telehealth, which kept our visit volumes about the same as before the pandemic. Registered Dieticians (RD) conducted telephonic outreach to make sure patients had what they needed; food, medications, etc. This began our virtual Nutrition Prescription Program where patients can learn the curriculum via telehealth. “Preventive health” as it relates to the most common chronic disease conditions was the overarching learning component throughout our 12-week course. This patient-focused approach to disease management supports continuing self-care and adoption of new methods for living healthy lives.


    Saratoga Hospital is performing very well in closing cancer screening measures such as cervical, breast and colorectal. Can you share your approach?

    Addressing food security during the pandemic helped us to build trust with our patients. These connections through telehealth counseling allowed regular contact with them and presented opportunities to discuss other health screenings. We kept visits in person when appropriate (for cervical cancer screening), but we also utilized screening strategies that did not require an in-office procedure such as Stool DNA testing. This screening follows U.S. Preventive Services Task Force(USPSTF) guidelines and can be collected at home. Many eligible patients elected to take advantage of these screenings.


    Open Door has had success engaging populations that may have challenges receiving childhood immunizations. What strategies did you implement to be so successful?

    We have a workflow in place where a nurse checks the New York State Immunization Information System (NYSIIS) vaccination registry for children who come in for a visit for any reason, not just a physical examination. If the child needs vaccination(s), the clinician discusses it with the parent or guardian, and the immunizations are given during the visit. We also use vaccine templates to assist in documentation. There is now reimbursement for vaccine counseling which pays for the work and time clinicians dedicate to discussing vaccines with patients, parents, or guardians.

    Our nurses also use the Relevant database to periodically outreach patients, both adults and children, who are missing vaccines per the Advisory Committee on Immunization Practices (ACIP)vaccine guidelines. We receive all ACIP recommended vaccines from Vaccine for Children (VFC) and Vaccine for Adults (VFA) which enables Open Door to offer free vaccines to our uninsured patients. We always have ample stock of vaccines on hand to close gaps in care.

    For school-aged children, Open Door has eight School-Based Health Centers (SBHC) which provide preventive primary care as well as acute care. The SBHC clinicians use the Relevant reporting system at Open Door to identify and close gaps in care, including immunizations.


    Saratoga Hospital is particularly good at getting patients with Diabetes to engage in condition management (eye exams and HbA1c testing). What do you attribute to your success?

    Providing Medical Nutrition Therapy (MNT) and Diabetes Self-Management Training (DSMT) services by an RD on-site, embedded into the practice makes a significant impact on patient engagement and clinical outcomes. The registered dietitian at the Community Health Center, Stephanie Samascott, completes warm hand offs from the primary care provider (PCP). This immediate connection to a new member on the patient's care team is instrumental in strengthening the patient's investment in their health. Injection education and diabetes technology training with patients coupled with chronic disease management classes and the Nutrition Rx program has been the magic formula to meet the needs of our patients with diabetes. Our registered dietician also works to improve the practice's quality measures by monitoring patient's lab results and notifying the providers when patients are due for updated labs.


    Open Door has performed well in prenatal/post-partum measures. What are the key drivers in this success?

    We have a Midwifery program with six midwives who provide prenatal and post-partum care. There is no access issue for these services. The midwives collaborate closely with each other to provide team-based care. There are dedicated prenatal and women's health nurses who track and reschedule appointment cancellations and no-show visits to ensure continuity of care for our patients.

    We thank the contributors of this discussion for bringing ideas, creativity, and patient-centered solutions for the continued health of their patients:


    Saratoga Hospital

    • Dr. Renee Rodriguez-Goodemote, MD, FAAAP
    • Dr. Karin Borrelli, MD
    • Stephanie Samascott, MS, RD, CDN - Registered Dietitian
    • Lisa Hodgson, RD, CDN, CDCES - Clinical Nutrition Manager

    Open Door Family Medical Center

    • Dr. Daren Wu, Chief Medical Officer
    As a Federally Qualified Health Center, Open Door provides top-notch health care to those who are hardest to reach, regardless of their ability to pay. Often, Open Door serves patients who may not otherwise have access to care – including low-income families and individuals without insurance.
    Saratoga Hospital is the Saratoga region's leading health care provider and the only acute-care facility in Saratoga County. The hospital’s multispecialty practice, Saratoga Hospital Medical Group, provides care at over 20 locations, delivering the programs and services that can have the greatest impact on individual and community health.
  • MVP Now Offers State Program Plans in Northern New York
    Published July 2023


    MVP is excited to share that we have expanded Medicaid, Health and Recovery Plan (HARP), Child Health Plus, and Essential Plan coverage options into eight New York State counties: Clinton, Essex, Franklin, Fulton, Hamilton, Herkimer, Montgomery, and St. Lawrence. Individuals have begun enrolling July 1, 2023 for coverage effective August 1, 2023. With the expansion of the service area, MVP will increase its ability to offer great care for individuals and families. MVP Medicaid, HARP, Child Health Plus, and Essential Plan coverage includes no co-pays for preventive care, including annual physicals and covered immunizations, $0 virtual care services, access to high quality doctors and hospitals, coverage for prescriptions, emergency coverage, and more. Along with our trusted Provider Partners, MVP is committed to serving the health and wellness of communities in these new areas. If you have questions about this expansion, please contact your MVP Professional Relations Representative.

  • New Integrated D-SNP Plan Now Available
    Published July 2023


    As of July 1, 2023, dual eligible individuals began enrollingin the new MVP DualAccess Complete (HMO D-SNP) plan. The MVP DualAccess Complete plan includes integratedbenefits for dually eligible enrollees (IB-Dual). IB-Dual is a DualSpecial Needs Plan (D-SNP) that offers Medicare Advantageand Managed Medicaid benefits with the same carrier.Members who receive Medicare Advantage and Medicaidbenefits through the same carrier have access to increasedintensive care coordination and efficient plan management. This is MVP’s second D-SNP plan. The Centers for Medicare &Medicaid Services (CMS) has awarded MVP’s D-SNP plan with 5stars for 2023, which is the only 5-star ranking in New York State. The new IB-Dual plan will be offered in the Capital District(Albany, Columbia, Greene, Rensselaer, Saratoga, andSchenectady counties), the Hudson Valley (Dutchess, Orange,Putnam, Rockland, Sullivan, Ulster, and Westchester counties),and Monroe county with benefits effective August 1, 2023. Providers can learn more at Members may visit

  • Coverage Crisis
    Published April 2023

    Public Health Emergency Unwind could put your patients’ coverage at risk

    Making sure that your patients continue to have the health coverage and access to care that you provide is our top priority.

    During the COVID-19 Public Health Emergency (PHE), patients enrolled in Medicaid, Child Health Plus (CHP), Health and Recovery Plan (HARP) and the Essential Plan(s) (EP) did not have to recertify their health insurance due to PHE continuous coverage requirements. This was part of the Families First Coronavirus Response Act that went into effect in March 2020.

    This is about to change. Recertification notices are being sent to enrollees starting this spring. These notices include deadlines for recertifying their insurance or risk being without coverage. Deadlines will be based on the enrollees’ enrollment end dates and will range from June 30, 2023, through May 31, 2024.

    CMS estimates 17% of enrollees may lose coverage as the products requiring recertification are based on meeting financial hardship requirements. Please be aware that for enrollees that are no longer financially eligible for Medicaid, CHP, HARP, or EP coverage, MVP offers Individual products through NYSOH, and premium assistance through the government may be available when purchasing an Individual plans. If your patient has questions, they can contact the MVP Customer Care Center at the number listed on the back of their MVP Member ID card.

    Outreach to MVP Members

    MVP is proactively contacting Members to ensure they receive important notifications from NYSOH regarding their recertification. Additionally, we are asking Members to be sure their mailing address, phone number, email address, and other contact information is up to date with NYS Medicaid and MVP, so that they receive important notifications.

    Let’s Collaborate to Keep Patients Covered

    MVP would like to:

    • Craft a plan with your practice or facility to address the health insurance enrollment, education, and advocacy needs of your patients and their families
    • Work with your practice or facility onsite to deliver MVP Plan Guides, conduct outreach, participate in events, and participate in the recertification and enrollment activities

    Together, we can minimize the negative impact of coverage gaps by working together to raise awareness with your patients. Please contact your MVP Professional Relations Representative with questions about how MVP can work with you and your staff.

  • Reminder: Medicaid Billing Rules for Family Planning and Reproductive Health Services
    Published April 2023

    Providers participating in the Medicaid Managed Care (MMC) Plan Provider network should bill family planning and reproductive health services to the relevant MMC Plan and not to Medicaid fee-for-service (FFS). All MMC Plans [including mainstream MMC Plans, Human Immunodeficiency Virus-Special Needs Plans (HIV-SNPs) and HARP include family planning and reproductive health services within their benefit package.

    Medicaid FFS Providers should ensure that MMC Plans are billed for family planning and reproductive health services provided to MMC enrollees (Providers must have a contract with the MMC enrollees’ MMC Plan to do so).

    Medicaid MMC enrollees may obtain family planning and reproductive health services from MVP Medicaid Provider. The following services provided to a MMC enrollee by an out-of-network Provider should be billed to Medicaid FFS:

    • Birth control drugs and devices, including Intrauterine Devices (IUDs), diaphragms, and other kinds of birth control
    • Emergency contraception
    • Sterilization for men and women
    • Pregnancy testing
    • An abortion that the patient and Provider agree is needed
    • HIV and sexually transmitted infections (STI) testing, treatment, counseling
    • Screenings for cancer and other related problems

    Questions and Additional Information

    • MMC enrollment, reimbursement, billing, and/or documentation requirement questions should be directed to the enrollee's specific MMC Plan. Providers can refer to the eMedNY New York State Medicaid Program Information for All Providers: Managed Care Information document for contact information per MMC Plan.
    • Medicaid FFS billing/claim questions should be directed to the eMedNY Call Center at 1-800-343-9000.
  • Welcome Chiropractic and Acupuncture Providers!
    Published January 2023


    MVP Health Care® (MVP) is pleased to welcome Chiropractic and Acupuncture Providers to its network in the State of New York effective January 1, 2023. To provide our Members with the highest quality care, we believe all health care should be integrated and viewed as equal components of overall well-being.


    MVP had contracted with eviCore healthcare MSI, previously known as Landmark for chiropractic and acupuncture services on behalf of MVP.


    Register for an MVP Online Provider Account

    To get started with MVP, register for a Provider Online Account. With your account, you can check claim status, determine Member eligibility, and much more.

    In 2022, MVP welcomed a new Chiropractic and Acupuncture network in the state of Vermont. We are thrilled with these partnerships.

  • MVP Provider Onboarding
    Published January 2023

    Online Resources for our new and existing Providers.

    MVP has developed a dedicated MVP Provider Onboarding resource which outlines everything Participating Providers need to do to get started with MVP as well as to acclimate you to the many resources available on our website. Whether you’re brand new to our network, have added a new provider to your practice, or just need refresher, we encourage everyone to explore this information to maximize your partnership with MVP. This information can be found on our Provider Onboarding page.


    Access Onboarding Resources

    Our Provider Onboarding resources are broken down into three sections:

    1. Getting Started
      Create an MVP Provider online account to check claim status, determine Member eligibility, and much more. You can also set up electronic claim submission and payments.

    2. Required Training and Attestations 
      To make sure that all Providers are in good standing with state and federal regulations and guidelines, MVP has outlined all required attestations. Some of these trainings are required on an annual basis and some are a one-time requirement. 

    3. MVP Resources 
      MVP has many resources available to help Providers stay informed and connected with us. Learn how to access our MVP Provider and Payment policies, Provider communications, forms, and more. You will also find educational materials for how to navigate your new MVP Provider Online Account and resources to help maintain your relationship with MVP.
      We hope that you find this information helpful no matter where you are on your journey with MVP, and that you bookmark this page as a resource for helpful information.

    We hope that you find this information helpful no matter where you are on your journey with MVP, and that you bookmark this page as a resource for helpful information.


  • Gia® Can Help Support Your Patients’ Needs
    Published January 2023

    MVP understands the increasing demands on Providers when it comes to meeting patient needs. Between the health crisis emergency we’re facing, where primary care practices do not have the ability to keep up with demand, and the over utilization of Emergency Rooms and Urgent Care facilities,the health care system is overwhelmed. To help ensure your patients get the care they need, we ask you to consider recommending Gia to MVP Members. Gia is a mobile app that allows Members to speak to doctors who can triage Members and help them get the care they need, either by answering questions, diagnosing when possible, or referring to in-person care from nearby doctors, specialists, labs, and pharmacies.

    By meeting our Members’ needs, we are removing the barriers to care – so your patients stay more engaged with their health care.

  • Gambling Disorder Treatment
    Published January 2023


    Effective January 1, 2023, MVP’s Managed Medicaid and HARP products will cover Gambling Disorder Treatment provided by Office of Addiction Services and Supports (OASAS) certified programs.

Register for a Provider Online Account

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