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7 Years - Partners Health Plan Gets Results

7 Years - Partners Health Plan Gets Results

Dear Members Families, & Friends,

We invite you to join us in celebrating PHP’s 7th Anniversary!

In 2016, we launched a non-profit organization and a new model of care for Individuals with Intellectual and Developmental Disabilities (IDD). We have delivered life-changing benefits and person-centered care coordination under a single and holistic plan. For the past seven years, we have been dedicated to improving lives.

We are very proud of what we have done to make healthcare more accessible to reduce health disparities. Below are highlights from last year.

Thank you for putting your trust in Partners Health Plan. We are grateful each and every day that we can assist members and families live their best lives!

With Gratitude

Kerry Delaney, CEO

What Did We Do in 2022?

We Excelled

  • An independent evaluation funded by the Centers for Medicare & Medicaid Services (CMS) reports that PHP’s innovative solutions like the pharmacy management program reduced errors, unnecessary emergency department visits, and length of hospital stays.

  • The telehealth program successfully resolved 90% of member’s concerns which prevented trips to the hospital.

  • More members completed colorectal cancer screening; diabetes testing and controls; controlled high blood pressure; completed annual dental visits and received annual flu vaccines compared to national and New York State health plans.

  • 90% of PHP members have received at least one dose of the primary COVID-19 vaccination.

  • 70% of the eligible members have received the booster dose.

We Talked About Diversity, Equity, & Inclusion

  • We expanded the Diversity, Equity, & Inclusion (DEI) Department, added more staff volunteers to our dedicated DEI council with representation from across the organization, held multiple cultural recognition forums and safe space conversations, and added to our DEI related education modules for staff.

We Expanded Our Services & Supports

  • We added 1,200 new providers, including Stonybrook Medicine enhancing our Network for members on Long Island.

  • Implemented an in-house Patient Care Assessment team to quickly get home care services in place.

  • New contracts with DentaQuest & Ridehealth to provide better dental & transportation services.

  • Partnered with Solvere Health to pilot specialized IDD mobile dental clinics at select-day service locations in Metro New York.

  • Over-the Counter (OTC) cards were added to the benefit package for more than 600 community members.

  • We launched a text messaging program to provide health care reminders, supporting preventative health care and wellness for our members.

We Supported You

  • Our Designated Representative Committee met 96 times to review more than 700 Life Plans.
  • PHP hosted 3 Member & Family meetings, Participant Advisory Committee meetings, family education sessions, and Peer Empowerment Group meetings.

We Advocated

  • Provided recommendations to OPWDD Commissioner Neifeld regarding COVID-19 protections for people with IDD.
  • Members and families testified before the General Assembly on the 2023-2027 OPWDD 5.07 Strategic Plan.
  • Members, families, and staff rallied at the NYS Capitol in support of Direct Support Professionals (DSPs).
  • Comments provided by PHP resulted in modifications to the proposed DOH 1115 waiver changes.

We Celebrated

  • PHP earned NCQA-Certification on the HEDIS Compliance Audit

7.13.24 UPDATE: ARPA Workforce Stabilization Payment Initiative

July 13, 2023

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the ARPA Workforce Stabilization Payment Initiative.

PHP was recently informed that OPWDD is working to effectuate the second installment of the pass-through ARPA payments by mid-August 2023.  Therefore, if PHP receives the pass-through proceeds mid-August 2023, we will immediately then disburse the funds such that they should be received by providers in the latter half of that month.  Consistent with the first ARPA Workforce Stabilization distribution in November 2022, the payments will be made in the form of a check. 

Just as a reminder, this installment will include funds associated with the following elements: 

  • Retention Payment (including any payments for those now attesting)
  • Vaccination Incentive (corrected surveys)
  • Longevity Payment (for those who were missing from the initial November installment as well as those now attesting)
  • COVID-19 Service (corrected surveys)

As soon as we receive an update as to when this funding is anticipated to occur, we will inform providers.

If you have any questions, please contact Provider Relations by opening a ticket here
Partners Health Plan 
Network Development and Provider Relations

8.23.23 UPDATE: ARPA Workforce Stabilization Payment Initiative

August 23, 2023

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the ARPA Workforce Stabilization Payment Initiative.

PHP was informed that the State is still working on the requisite details to finalize the provider pass-through amounts and therefore the payments will not be distributed mid-August.   As soon as we receive the updated timing as to when the payments will occur we will send a communication to you. 

Just as a reminder, this installment will include funds associated with the following elements: 

  • Retention Payment (including any payments for those now attesting)
  • Vaccination Incentive (corrected surveys)
  • Longevity Payment (for those who were missing from the initial November installment as well as those now attesting)
  • COVID-19 Service (corrected surveys)
If you have any questions, please contact Provider Relations by opening a ticket here
Partners Health Plan 
Network Development and Provider Relations

Are You Concerned About Diabetes?

If You Are Concerned About Diabetes

Diabetes is a disease that affects how your body turns food into energy. A lot of what you eat turns into sugar (glucose) and goes into your blood. As your blood sugar goes up your body produces insulin to let the blood sugar go into cells to produce energy. If you have diabetes your body doesn’t produce insulin (Type 1) or the cells don’t respond to insulin (Type 2), so too much sugar stays in your blood. 

The biggest health risks of diabetes are associated with high blood sugar, which can increase the likelihood of blood clots and impaired blood flow by making cells sticky and blood vessels stiff.  This can damage tissues, resulting in high blood pressure, heart attacks, stroke, kidney failure, blindness, and skin infections, especially on the feet. A blood test called Hemoglobin A1C (HgbA1c) can measure the effects of blood sugar on their cells over time.  Regular measures of blood sugar will allow a person with diabetes or pre-diabetes to take measures to reduce their risks and improve their health.   

Making deliberate food choices is an excellent way to manage your weight, which makes a difference to controlling diabetes. Here are some tips: 

  • Load up on proteins first-don’t leave yourself feeling hungry by the time you get to those side dishes!
  • Choose high-quality plant-bases carbs instead of sugary items (e.g. sweet potatoes minus the marshmallows) 
  • Portions should always be small, with a variety of colors and textures-try shaving your veggies-looks are deceiving, so you’ll load your plate without needing large portion!
  • Keep moving! Helping to set/clear the table are simple ways to get some steps in!
  • Holiday baking can swap out white flour for a variety of options-no need to skip dessert if you plan right when baking!

Schedule activities such as walking, taking stairs, gardening, house cleaning, playing with a pet, anything that gets you moving!   

If you have diabetes, we are here to support you, your care manager can assist you with making sure you see your PCP and specialist if needed (Diabetes doctor called an Endocrinologist). To support your best health, it is important to see your doctors regularly and make sure you take all medications as prescribed. Your doctor may take a blood sample to check your A1c (this is a test to check how much sugar has been in your blood over the last few months), this test is a great way to see how you have been doing managing your diabetes. 

Schedule a visit with your doctor. And it’s always a good idea to have someone you trust come with you. Sometimes when we get to the doctor, we get nervous and don’t always hear what the  

doctor is saying. Having a second pair of ears helps. Also, that person can help you remember all your questions and give you support during an exam the doctor may need to do. 

Remember if you have any questions or need help to make an appointment, find a doctor to support you or need help getting your medication, your care Manager is here to help. For more information check out this helpful flyer.

Details can be found: 

Actual recipes: and 

Visit Partners Health Plan's Health Resources to learn more about the diabetes as well as other informative health-related articles.


H9869_Diabetes Article_2022

ARPA Workforce Stabilization Payment Initiative Update

February 2, 2023

Dear Provider:

Partners Health Plan (PHP) wants to provide you with an update regarding the ARPA Workforce Stabilization Payment Initiative. PHP distributed the FIDA pass-thru portion of the cost-based Longevity payment and the survey-based COVID-19 Service payments in November 2022.

With respect to distribution timing for the Retention and second half of the survey-based balances and for any omissions or corrections related to the Longevity payment and the survey-based funds paid in November, to date we have not received guidance yet from the State. As always, we will immediately share any updates that are received from the State. 

For providers that either did not submit the requisite attestations to acquire Retention or Longevity cost-base funds or need to correct COVID-19 survey data, OPWDD recently published information about one-time vehicles to do so. PHP would encourage providers to contact OPWDD for more information if either of these scenarios might apply to them.  If you have any questions please contact us at This email address is being protected from spambots. You need JavaScript enabled to view it.


Partners Health Plan

Network Development and Provider Relations

Do you have questions or concerns for the Network Development and Provider Relations team? Please CLICK HERE to submit a ticket to receive assistance.


BronxNet Highlights Partners Health Plan's Specialized Dental Care Services

BronxNet Highlights Partners Health Plan's Specialized Dental Care Services

Karleen Haines, Chief of Member Relations and Advocacy, appeared on the BronxNet OPEN to discuss the Partners Health Plan (PHP) non-traditional care management model that will be offering specialized dental care services for PHP members-- enrollees with Intellectual and Developmental Disabilities (IDD)-- via mobile dental clinics in a partnership with Solvere Health.

PHP is the first-in-the-nation, non-profit, provider-led managed care organization, designed by IDD experts, that fully integrates Medicare and Medicaid for individuals 21 years and older with IDD. 

Capitol Pressroom Interview with COO Courtney Skivington-Wolf, RN

In the News

Capitol Pressroom Interview with COO Courtney Skivington-Wolf, RN

Partners Health Plan Chief Operating Officer Courtney Skivington-Wolf, RN was interviewed by the Capitol Pressroom, a daily public radio program that reaches more than two dozen stations across New York. Host David Lombardo spoke to Courtney about the specific needs and challenges associated with vaccinating people with Intellectual and Developmental Disabilities for the flu and COVID-19. Click here to listen to the interview.

Celebrating 6 Years: A Time to Look Ahead

This month we celebrate the PHP FIDA-IDD Plan’s 6-year birthday!

It was April 1, 2016, that the Centers for Medicare & Medicaid Services (CMS) and New York State began enrollment in New York, Long Island, Rockland & Westchester counties for the Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) Plan. It was designed to test a new model of care for providing Medicare-Medicaid enrollees with Intellectual and Developmental Disabilities (IDD) an opportunity to experience a more integrated, coordinated, and person-centered care focused on individuals’ long-term health and well-being so they may live a quality life.

PHP FIDA-IDD members have more opportunities to direct their own services, be involved in care planning, and live as independently in the community as possible.  Click here for PHP member stories.

As we celebrate the FIDA-IDD’s 6th birthday, we recognize the commitment of our staff to helping our members achieve their goals and the positive healthcare outcomes they deserve. We look forward to the future and to bringing more options and opportunities for our members.

Kerry Delaney, CEO, Partners Health Plan

Clinical Brief: Medical Care of the IDD Patient

Clinical Brief: Medical Care of the IDD Patient

Ensuring Optimal Outcomes in Patients with Intellectual and Developmental Disabilities
- Steven Merahn, MD - Medical Director

Table of Contents

IDD and Polypharmacy Risks

Individuals with intellectual and developmental disabilities (IDD) have a 2.5 times higher prevalence of chronic comorbid physical health conditions than adults with no limitations. The chronic conditions most associated with IDD include but are not limited to:

  • Psychiatric conditions                     

  • Epilepsy                                  

  • Asthma

  • Dental disease

  • Osteoporosis

  • Gastrointestinal disorders

  • Obesity

And with the increasing life expectancy of the IDD community due to improvements in access to and provision of healthcare and other services, the prevalence of conditions commonly associated with aging also increases, especially diabetes, hypertension, and hypercholesterolemia.

With the prevalence of both behavioral and physical health conditions in this population, the risks associated with polypharmacy rise dramatically. In one study of adults with IDD over age 40, 32% were found to have polypharmacy (defined as 5-9 medications) and 20% were found to have excessive polypharmacy (10+ medications) based on regular use of both prescription and over-the-counter medications. Individuals with IDD in residential facilities had 4 times the rate of excessive polypharmacy vs. community living (group home/independent living), independent of other factors.

Polypharmacy is directly associated with increased risks for adverse drug events (ADEs). In a well-controlled study comparing the proportion of hospitalizations associated with ADEs for adults with IDD vs adults from the general population in the United States, the rate of admissions for the IDD population was almost 2.5 times that of the general population. In addition to polypharmacy, the relevant variables for this admission include impaired cognition, multiple comorbidities, dependent living situation, and nonadherence to medication regimens. While the overall incidence of ADE admissions is low compared to admissions for other ambulatory care sensitive conditions, these findings have important clinical relevance due to the associated increased prevalence in this population of acute conditions such as UTI, respiratory, musculoskeletal, and gastrointestinal conditions—the associated challenges of coordination or communications between different groups of providers. Any single clinician should have access to the patient’s complete medication list, and regular medication reconciliation should take place by the primary care team in collaboration with the patient’s care manager.

The 2018 Canadian Consensus Guidelines on primary care of adults with intellectual and developmental disabilities makes the following recommendations:

  • Every three-month medication review for indications, dosing, effectiveness, and ADE risk, involving a clinical pharmacist whenever possible, especially for those medications with drug-organ or drug-drug interactions.

  • Educate patients and caregivers about appropriate use of medications, interactions with over-the-counter, alternative, and as-needed medications, and to report potential adverse drug events. Simplify the medication administration routines and recommend appropriate medication administration aids (e.g., dosettes or blister packs) and other needed supports.

  • Determine the patient’s capacity and need for supports for both decision making and medication adherence and engage caregivers and care managers whenever possible.



Erickson SR, Kamdar N, Wu CH. Adverse Medication Events Related to Hospitalization in the United States: A Comparison Between Adults With Intellectual and Developmental Disabilities and Those Without. Am J Intellect Dev Disabil. 2020 Jan;125(1):37-48doi: PMID: 31877264.

O'Dwyer M, Peklar J, McCallion P, McCarron M, Henman MC. Factors Associated with Polypharmacy and Excessive Polypharmacy In Older People With Intellectual Disability Differ From the General Population: A Cross-Sectional Observational Nationwide Study. BMJ Open. 2016 Apr 4;6(4):e010505. doi: 10.1136/bmjopen-2015-010505. PMID: 27044582; PMCID: PMC4823458.

Sullivan WF, Diepstra H, Heng J, Ally S, Bradley E, Casson I, Hennen B, Kelly M, Korossy M, McNeil K, Abells D, Amaria K, Boyd K, Gemmill M, Grier E, Kennie-Kaulbach N, Ketchell M, Ladouceur J, Lepp A, Lunsky Y, McMillan S, Niel U, Sacks S, Shea S, Stringer K, Sue K, Witherbee S. Primary Care of Adults With Intellectual and Developmental Disabilities: 2018 Canadian Consensus Guidelines. Can Fam Physician. 2018 Apr;64(4):254-279. PMID: 29650602; PMCID: PMC5897068.  

Team-based Service Coordination in Practice: Working with Care Managers

What is commonly called “team-based care” is well established to improve stability and outcomes for individuals with medical complexity, especially including patients with intellectual and developmental disabilities (IDD). The American College of Physicians, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetrics and Gynecology have all reviewed the evidence and endorsed “team-based care” as an optimal model for such special needs populations.

However, what does “team” mean? The nature of the team structure, the roles and responsibilities of team members, and the relationship among team members who may not all have the same organizational affiliation are always challenging when trying to coordinate care for an individual with multiple, diverse disciplinary needs. 

Individuals with IDD often have complex “health resource communities,” meaning those individuals, organizations, entities, and environments (including the patient and their family) that have any involvement or influence—actual, virtual, or potential—on the variables that influence their health and well-being.

In our current systems of practice, the responsibility for the elements of any patient’s care is often apportioned independently among different professional disciplines (primary care and specialist physicians, nurses, therapists, social workers, etc.) who, based on the mental model of their discipline, contributes insights and any related orders or action items.

Unfortunately, when decisions are made in isolation of other members of the patient’s health resource community, it can lead to fragmented and uncoordinated care, adding risk to the patient and family, especially those with IDD.

Even under an interdisciplinary model, teamwork is really “groupwork”: while all necessary domains may be represented, members actually work in parallel on tasks that match their purview; achievement of individual goals among the team members is expected to add up to the groups purpose. 

However, interdisciplinary is not the same as integrated. And the diverse, often complex needs of the IDD community can often stress the capacity of individual providers. As noted in the 2018 National Academy of Medicine discussion paper “Optimal Team-Based Care to Reduce Clinician Burnout,” well-defined team-based care presents a unique opportunity to improve patient outcomes, the efficiency of care, and the satisfaction and well-being of health care clinicians.

High performance goal achievement in environments characterized by complexity and diverse human factors requires sharing responsibility, authority, and accountability among team members. To be successful, this model of collaboration must be based on a belief that the benefits of collaboration will offset perceived costs such as loss of autonomy and territorial control. Then, care delivery becomes a collective enterprise as opposed to a departmental, command and control phenomenon, with active coordination of goals and activities to effectively resolve complex problems that could have dire consequences in the face of failure.

In the symphony, performers use their instruments in collective effort to create a harmonious and moving experience for the audience. Extraordinary collective performance—whether in technology, special forces, or healthcare—is also symphonic: dozens of technical and interpretive experts, each of whom has invested in mastering their specific instrument or craft, come together, subsume their individual identities, and, in a shared effort, are able to create a concordant, goal-directed experience. 

The conductor is not the leader, but serves an essential integrating role, holding the vision for the performance as a whole. Even the most virtuoso players understand they cannot conduct and sit first chair; they respect, trust, and defer to the conductor and listen carefully—not for reaction, but for connection—to their fellow players, because they understand that a solo may be in their hands, but the symphony only exists in the collective effort.

In our current systems of care, a well-trained and comprehensive Care Manager is the ideal “conductor,” serving an essential integrating role, holding the vision for “whole-person” outcomes. Their expertise is orchestrating collaboration and a single focus on facilitating the goal-directed activities of team members.

However, it’s important to understand that there are many different forms of care management. Knowing the specifics of an organization’s care management model will help you make better decisions as to who is on your team for specific patients. For medically complex patients, such as those with IDD, Care Managers should be open to augmenting your staff and engaging in activities that promote access to care. They will also help patients and families navigate the healthcare system, identify, and engage referrals, coordinate and support the management of transitions of care (home/residence to hospital, hospital to skilled nursing facility or SNF, SNF to home/residence), follow-up on emergent or urgent care needs and provide linkages to social and government services, community supports and long-term care, and hold interdisciplinary team meetings. They can also conduct or refer for specialized functional and risk assessments, which can add to the data used in your practice for decision making and quality improvement. That data will be useful to create integrated patient-centered plans of care based on IDD best practices to ensure appropriate access to resources and services, including preventive interventions, safety plans, and necessary equipment.

For example, New York State (NYS) has developed a care management model for the IDD community that is used in the IDD-focused Care Coordination Organizations/Heath Homes (CCO/HHs). The CCO/HH model offers a unique, well-defined and predictable level of service that can offer great value to healthcare services organizations. Care Managers at CCO/HHs and CCO-associated health plans have extensive experience working with individuals with IDD; some are Qualified Intellectual Disabilities Professionals (QIDP). As the primary relationship managers for patients and families eligible for services under NYS Office of People With Developmental Disabilities (OPWDD), Care Managers can serve an “essential integrating function” in your practice. While most health plans offer their own form of care management, some health plans choose to partner with CCO/Health Homes for IDD patients because of their model of care and disciplined performance.



Collaboration in Practice: Implementing Team-Based Care. Pediatrics. 2016 Aug;138(2):e20161486. Available from: doi: 10.1542/peds.2016-1486. PMID: 27456515.

Doherty R, Crowley, R. Health and Public Policy Committee of the American College of Physicians. Principles Supporting Dynamic Clinical Care Teams: An American College of Physicians Position Paper. Ann Intern Med. 2013 Nov 5;159(9):620-6. PMID: 24042251.

Mitchell P, Wynia M, Golden R, McNellis B, Okun S,  Webb E, Rohrbach V, Von Kohorn I. Core Principles & Values of Effective Team-Based Health Care. NAM Perspectives. Discussion Paper, National Academy of Medicine, 2013.Available from:  

New York State Department of Health, New York State Office for People With Developmental Disabilities [Internet]. Care Coordination Organization/Health Home (CCO/HH) Provider Policy Guidance and Manual. 2018 Aug; Ver 2018-1. Available from:

Smith, C, Balatbat C, Corbridge S, Dopp A, Fried J, Harter R, Landefeld S, Martin C, Opelka F, Sandy L, Sato L, Sinsky C. Implementing Optimal Team-Based Care to Reduce Clinician Burnout. NAM Perspectives. Discussion Paper, National Academy of Medicine. 2018. Available from:

Advance Care Planning and IDD

Adults with IDD have made significant gains in longevity in the last twenty years. Between 2008 and 2017, the average lifespan for adults living with these disabilities (which include intellectual disabilities, Down syndrome, and cerebral palsy) rose more than for adults without IDD. However, there remain disparities in lifespan from other non-disabled adults, with variation by type of disability: individuals with cerebral palsy have a significantly shorter lifespan (23 years fewer than non-disabled adults) than those with primary intellectual disabilities (12 years fewer).

In addition, racial and ethnic minorities with IDD have additional risks: a wide gap exists in the average age at death between non-Hispanic white adults with IDD and their peers in other racial/ethnic groups. By way of example, non-Hispanic white adults with IDD live nine years longer, on average, than Black and Native American adults with IDD and 12 years longer than Hispanic/Latino adults with IDD.

With their growing life expectancy, the numbers of older adults with IDD continues to expand, and community agencies and families now face the challenge of providing supports as these adults experience age-related changes. In comparison with adults without long-term disabilities, adults with IDD are more likely to experience earlier age-related health changes, limited access to quality health care, and fewer financial resources. In addition, they are more likely to be living with parents into adulthood and have more limited social supports and friendships outside the family.

This all speaks to the need for Advance Care Planning (ACP) in early adulthood for individuals with IDD.  Getting started early sets the foundation for the individual’s future, especially because the ACP is not a singular act, but an ongoing process that best practices say should be reviewed at least annually and/or with any significant change in status. 

The overarching goal of the ACP is to improve the quality of the end-of-life experience for both the person who is dying and their caregivers by increasing the likelihood of adherence to the person’s wishes when they become seriously ill and reach life’s end. The outcomes in these situations are significantly better when the ACP process is carried out effectively.

Many barriers to ACP exist, enhanced by the presence of IDD. There is a tendency to think that individuals with IDD lack the capacity to understand the issues at hand and to be more reactive than proactive when it comes to ACP for these individuals, thus often delaying conversations until the final stages of an advance illness in response to worsening prognosis and/or a change in care needs. Caregivers, including both ageing parents and adult siblings, are often reluctant to engage in future planning because they fear it may affect the care their loved one receives, lack an understanding of the process, and have fears related to their own mortality. This is validated by a study that found people with intellectual and developmental disabilities to be less self-determined in the domain of end-of-life planning when compared to people without disabilities.

Despite these barriers, opportunities for meaningful ACP exist for people with intellectual and developmental disabilities and those who support them. Fostering effective relationships between people with intellectual and developmental disabilities, their caregivers, and healthcare providers can ensure the wishes of the person as central to the decision-making process.

The two concepts that drive the ACP process are the capacity and competency of the individual involved; capacity can be supported with assistance. While many people with IDD are inaccurately presumed to lack capacity, a 2014 Institute of Medicine report noted that while some people with IDD may lack decision-making capacity for certain medical decisions, they may retain capacity for other decisions, including the selection of a proxy or healthcare agent.

Competency is more complex, grounded in the question: Is this person 18 years of age or older and considered legally competent under the law to make their own medical decisions? If not, surrogate decision makers can be appointed; surrogates can be relatives, friends, caregivers, or healthcare providers.

The facilitator of the ACP does not need to be the primary care physician, and the role can be assigned by them to other, non-clinical personnel, such as a social worker, nurse, or care manager who is knowledgeable of, and comfortable with conversations related to death and dying, and skilled at communicating about these subjects with people who have intellectual and developmental disabilities and their relatives. The facilitator must also thoughtfully and intentionally engage the person and their relatives so that they have the information needed to make informed decisions, understand their roles in the process, and ultimately have a positive experience.

People with intellectual and developmental disabilities can and should be engaged in the ACP process. Recent research has found these individuals to have the capacity and interest to participate in ACP, especially when person-centered accommodations are made, and shared decision-making is facilitated by healthcare staff. Person-centered planning assumes that people are authorities in their own lives and, as such, deserve agency in deciding what services they receive and how they are provided. This imperative extends to ACP.


American Association on Intellectual and Developmental Disabilities (AAIDD). Health, Mental Health, Vision, and Dental Care Joint position statement of AAIDD and The Arc. 2013 Feb 20. Available from:

Institute of Medicine (IOM). Dying in America: Improving quality and honoring individual preferences near the end of life. The National Academies Press. 2014.

Landes S, McDonald K, Wilmoth J, Carter G.  Evidence of Continued Reduction in the Age-at-Death Disparity Between Adults with and without Intellectual and/or Developmental Disabilities. Journal of Applied Research in Intellectual Disabilities. 2021 May; 34(3): 916-920. Epub 2020 Nov 27. PMID: 33247487.

Landes S, Wilmoth J, McDonald K, Smith A. Racial-Ethnic Inequities in Age at Death Among Adults With/Without Intellectual and Developmental Disability in the United States. Preventive Medicine. 2022 Mar; 156:106985. Available from: 10.1016/j.ypmed.2022.106985. Epub 2022 Feb 9. PMID: 35150747; PMCID: PMC8885978.

McGinley J, Knoke V. Conceptualising Person-Centered Advance Care Planning for People with Intellectual Disabilities: A Multifaceted Theoretical Approach. Ethics and Social Welfare. 2018 Aug 14;12(1):1-15, Available from: 10.1080/17496535.2018.1505929

Stein G (Wurzweiler School of Social Work Yeshiva University) Advance Directives and Advance Care Planning for People With Intellectual and Physical Disabilities. Report. Office of Disability, Aging and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services. 2007 Oct. Available from:

Voss H, Vogel A, Wagemans A, Francke A, Metsemakers J, Courtens A, deVeer A. Development, Implementation, and Evaluation of an Advance Care Planning Program for Professionals in Palliative Care of People with Intellectual Disability. Intellectual Developmental Disabilities. 2021 Feb 1;59(1): 39-54. PMID: 33543280.

Behavior Management in Practice: Practical Considerations

Individuals with intellectual and developmental disabilities (IDD) may demonstrate behaviors that vary from your neurotypical patients. These can manifest themselves on a spectrum ranging from differences in:

  • Cognitive, communication, social, emotional, adaptive functioning, to

  • Hyperactivity, impulsivity, routines or stereotypy, mood liability, vocalizations, to

  • Physical aggression, self-harm.

Identifying, differentiating, and adapting the response of the practice to what is normative for the patient versus what may require therapeutic intervention is essential to ensuring a non-disruptive encounter. Some patients with autism, for example, use self-stimulation such as rocking, finger flicking or other hand movement, or even pacing to help them concentrate during social encounters that may otherwise be overwhelming. Other patients may regularly spontaneously vocalize in a way that might be associated with pain in another person. The practice needs to accept these behaviors as part of the patient’s person-hood. At the same time, behaviors that are barriers to well-being such as self-harm or impulsive elopement may require assessment and associated interventions.

Most behavior management does not take place in the primary care or medical specialists office, but there are some behavioral techniques that can help practices manage the variations in behavior of the IDD patients.

These techniques are generally called the “common factors” because they are not specific to any one condition but are elements of effective communication skills that positively affect outcome, regardless of diagnosis. They are grounded in three key principles focused on managing complex care and enabling acceptance and commitment to plans of care (including self-management):

  • Fostering relationships to improve therapeutic alliances,

  • Improving information exchange to support better informed, shared decision making, and

  • Increasing patient/family participation in care by responding to emotions through listening and offering acknowledgment, legitimation, empathy, and support.

The “common factors” techniques to be used in practice are grounded in the mnemonic HELP (Figure 1). There is significant evidence that medical generalists can readily apply these techniques in practice with limited training.


American Academy of Pediatrics. Addressing Mental Health Concerns in Primary Care: A Clinician’s Toolkit. 2010.Toolkit 2-page snippet available from:

Epstein R, Duberstein P, Fenton J,  Fiscella K, Hoerger M, Tancredi D, Xing G, Gramling R, Mohile S, Franks P, Kaesberg P, Plumb S, Cipri C, Street R Jr, Shields C, Back A, Butow P, Walczak A, Tattersall M, Venuti A, Sullivan P, Robinson M, Hoh B, Lewis L, Kravitz R. Effect of A Patient-Centered Communication Intervention on Oncologist-Patient Communication, Quality of Life, and Health Care Utilization in Advanced Cancer: The VOICE randomized clinical trial. JAMA Oncol. 2017 Jan 1;3(1):92-100. Available from: doi: 10.1001/jamaoncol.2016.4373.

Kessler R. Mental health care treatment initiation when mental health services are incorporated into primary care practice. J Am Board Fam Med. 2012 Mar-Apr;25(2):255-9. Available from: doi: 10.3122/jabfm.2012.02.100125. PMID: 22403211.

Rudy L. What Is Stimming? Verywell Health. 2022 Oct 16.  Available from:

Wissow L, Anthony B, Brown J, DosReis S, Gadomski A, Ginsburg G, Riddle M. Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care. Administration Policy Mental Health. 2008 July; 35(4): 305–318.Epub 2008 Jun 10. PMID: 18543097; PMCID: PMC4002282.

Wissow L, Gadomski A, Roter D, Larson S, Brown J, Zachary C, Bartlett E, Horn I, Luo X, Wang M. Improving Child and Parent Mental Health in Primary Care: A Cluster- Randomized Trial of Communication Skills Training. Pediatrics. 2008 Feb;121(2):266–275. Available from: doi: 10.1542/peds.2007-0418. PMID: 18245417.

DentaQuest Selected by Partners Health Plan to Administer Dental Benefits for Individuals with Intellectual and/or Developmental Disabilities in New York

DentaQuest, one of the nation’s largest and most experienced Medicaid dental benefits administrators, today announced its new engagement with Partners Health Plan (PHP) to increase access to oral health care and improve outcomes for individuals with intellectual and/or developmental disabilities (I/DD).

Partners Health Plan (PHP), a nonprofit managed care organization serving individuals with I/DD, selected DentaQuest to administer dental benefits and specialized services for its members. With the addition of PHP to its other government clients, DentaQuest now serves 63% of Medicaid enrollees in the state.

“We are honored to support Partners Health Plan in its commitment to serving adults with I/DD,” said Steven Pollock, president of DentaQuest. “We’ve long recognized the importance of increasing health equity for all, and health plans like PHP that focus on underserved populations are critical to making it happen. Oral health is often overlooked as more immediate medical needs take precedence, but as we know good oral health drives overall health and everyone can benefit from routine, preventive care. Innovative approaches, such as our industry-leading case management program, provide an extra level of support for individuals with I/DD and their caregivers to navigate a complex, imperfect health system to ultimately get the right treatment, at the right time.”

DentaQuest’s case management program helps identify appropriate resources needed to resolve a member’s issue – often unrelated to health care – and coordinates access to those resources with PHP care managers to ultimately achieve optimal oral health. Together, DentaQuest’s case management team and PHP care managers partner to secure transportation, medical clearance, sedation and anesthesia, hospital level care and other dental services.  The collaboration between PHP and DentaQuest has led to a substantial increase in member utilization and appears to be addressing long standing access challenges faced by the I/DD population.

Launched in 2016, PHP develops and coordinates personalized life plans that ensure participants receive the essential medical, behavioral, dental, habilitation, and other services and supports needed. Dental care is the primary unmet need for adults with I/DD. More than 30% of children with I/DD are likely to have their first dental visit delayed, and in general, individuals with I/DD are less likely to receive necessary restorative care. Addressing this disparity is a critical component in impacting overall health equity for individuals with I/DD, as poor oral health can result not only in dental caries and gum disease, but can impact overall health, potentially leading to heart disease, cancer, and diabetes.

“The work we are accomplishing with DentaQuest shines a light on what is possible across the nation – people with I/DD deserve and can achieve lifelong optimal oral health and wellness when we create the right partnerships and invest in the right programs,” said Kerry Delaney, CEO, PHP. “We look forward to continuing our partnership and the measurable results we are seeing in dental care for PHP members.”

In the future months, PHP will also be piloting teledentistry and mobile dentistry programs in partnership with DentaQuest to increase access to oral health care for members.

About DentaQuest

DentaQuest is a purpose-driven health care company dedicated to improving the oral health of all. We do this through Preventistry® — our inclusive approach to quality care and expanded access built on trusted partnerships between patients, providers and payors. As one of the nation’s largest and most experienced Medicaid dental benefits administrators, we manage dental and vision benefits for more than 33 million Americans through a nationwide network of providers in all 50 states. Our outcomes-based, cost-effective dental solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. At the same time, we are expanding our footprint of more than 70 oral health centers in six states to deliver direct patient care in rural and underserved populations. Learn more at and follow us on FacebookInstagramLinkedIn, and Twitter.

About Partners Health Plan

Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit

eFMAP Funds Update

eMAP Funds Update

August 2022: Once again, Partners Health Plan wants to provide an update regarding NYS Workforce Stabilization Longevity and Retention Supplemental pass-thru payments that we will be distributing on behalf of NY State.

We have not received guidance with respect to timing since our July 6, 2022 communication to you. As always, we will immediately share any updates that are received from the State.

As a reminder, the Workforce Stabilization Longevity and Retention Supplemental pass-thru distributions will be made via hard-copy check. Because we want to make sure the funds are received timely, we have been collecting addresses from providers specifically for the mailing of this payment. If we do not receive your billing address confirmation form, the Workforce Stabilization Longevity and Retention Supplemental pass-thru payments will be mailed to the billing address we have on file in our claims system.

If you would like to guarantee that the checks are distributed correctly please complete the form at the following link:
→ Provider Billing Address Form.

As always if you have any questions, please contact us at providerrelations@​phpcares.​org.

See below for all previous communications with providers regarding the NYS Workforce Stabilization Longevity and Retention Supplemental Pass-thru Payments and the request for Provider Billing Information.

End of Public Health Emergency – How will this Impact the use of StationMD for Behavioral Health?

End of Public Health Emergency:
How will this Impact the use of StationMD for Behavioral Health?

As you know, PHP has been working with StationMD since 2018, the outcomes from this benefit for members has been extremely positive and we will continue our relationship with StationMD as we move past the Public Health Emergency.

We wanted to share some updates as to how this will change some of the flexibilities that were allowed over the past 3 years. The national public health emergency (PHE) is scheduled to end on May 11, 2023. The PHE granted StationMD some flexibilities related to their operations, with the end of the PHE, there will be some impacts to StationMD practices, the main effect is around the prescription of controlled medications.

For StationMD’s Urgent/Emergent line of business to be compliant with federal DEA regulations, after May 11, 2023, their urgent care service line clinicians will no longer be able to prescribe controlled substances. All other urgent care services will remain in place. This currently represents <1% of all calls, and we continue to encourage members to utilize StationMD for urgent supports including those related to medications, the StationMD physician can advise if a requested or needed medication is on the controlled substance list and something they cannot provide in their capacity.

 For StationMD’s Behavioral Health line of business, to be compliant with federal DEA regulations, after, May 11, 2023, their behavioral health practitioners will only be able to prescribe controlled substances if a qualified telemedicine referral is obtained. The DEA details specific requirements for this referral. The referral must be obtained from a physician, nurse practitioner, or a physician assistant that has a DEA license in the state the patient resides and has seen the patient, in person, for a medical reason. It must have the patient demographics, the referring clinician’s name and NPI, the consulting clinician’s name and NPI, a list of diagnoses, list of medications, and a treatment plan. Most commonly, the patient’s primary medical provider can complete the referral, but it can be any provider that meets the above requirements.

Members who currently receive behavioral health supports from StationMD have been contacted regarding the steps required to continue working with their current StationMD provider and all future referrals will include the appropriate physician referral as part of the intake packet.

StationMD Logo

Need Provider Assistance?

The Partners Health Plan Network Development and Provider Relations team is here to assist you with your billing, claims, authorization, education, and any other general inquiry. Use the Contact Us button below to complete a Provider Ticket Submission Form.

Contact Us

Health Care Options Expanded for PHP Members: Stony Brook Medicine Joins PHP Provider Network

BRONX, NY, October 4, 2022— On September 1, 2022, Stony Brook Medicine joined the Partners Health Plan (PHP) provider network offering services to PHP members.
Kerry Delaney, PHP CEO stated, “We are very happy to welcome them back into our network. This will expand care options for PHP members. Stony Brook Medicine is an extensive health care system. It includes three acute care hospitals and many affiliated specialty groups and physicians with specialized services for individuals with Intellectual and Developmental Disabilities (IDD). This relationship will deepen the care choices that PHP members and their families have come to expect from us in providing state-of-the-art supports and services.”
For more information on the Stony Brook Medicine providers and locations that are now part of the PHP provider network, please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..
About the facilities and services in the Stony Brook Medicine – PHP relationship
3 Acute Care Hospitals:
• Stony Brook University Hospital, Stony Brook, NY
• Stony Brook Eastern Long Island Hospital, Greenport, NY
• Stony Brook Southampton Hospital, Southampton, NY
Affiliated specialty groups and physicians that offer the following services:
• Ambulatory Health Centers
• Cardiovascular Disease
• Dialysis
• Family Medicine
• GI and Hepatology
• Inpatient/Outpatient Psychiatry
• Mammography
• Oncology
• Orthopedics
• Podiatry
• Radiology
• Sleep Disorders
• Urology

Important eFMAP Funds Update from Partners Health Plan

Important eFMAP Funds Update

October 27, 2022

Once again, Partners Health Plan (PHP) wants to provide an update regarding the NYS Workforce Stabilization Longevity and Retention Supplemental pass-thru payments that we will be distributing on behalf of NY State.

We have been notified that the Department of Health (DOH) has received the necessary approval to fund the two Calendar Year 2021 ARPA Workforce Stabilization Initiatives – the cost-based Longevity Payment and the survey-based COVID-19 Service Payment. DOH has provided PHP with the specific provider award amounts to be paid to each provider. PHP is scheduled to receive the related pass-thru funds from DOH in the third week of November 2022. We will remit the payments to providers according to the list provided by the DOH shortly thereafter.

As we previously informed you, the payments will be made in the form of a check.  Unless we have been provided payment instructions pursuant to our previous solicitations specific to this process, payments will be sent based on provider-payment information from our claim system.

More details will follow as we get closer to the third week of November. 

If you have any questions, please contact us at providerrelations@​phpcares.​org.

Medical Director Dr. Steven Merahn, MD Featured on ABA Podcast

Medical Director Dr. Steven Merahn, MD
Featured on ABA Podcast

An amazing podcast, Building Better Businesses in ABA (Applied Behavior Analysis), featured Partners Health Plan Medical Director, Dr. Steven Merahn, MD.

Dr. Merahn shares his views on health as a social imperative to equitably improve the ability for individuals with IDD to succeed in the world on their own terms and participate authentically as active members of family and community.  

Members Only Event: Partners Health Plan (PHP) Seeks to Overcome Dental Health Disparities For Individuals with IDD

Members Only Event: Partners Health Plan (PHP) Seeks to Overcome Dental Health Disparities For Individuals with IDD

Specialized Dental Care for those with Intellectual and Developmental Disabilities (IDD) Comes to Metro NY.

January 9, 2023 — New York
Individuals with Intellectual and Developmental Disabilities (IDD) are known to have poorer oral/dental health than people without IDD. Studies show that people with IDD have 30% more untreated cavities, 50% more missing teeth, and 150% more gum disease.

The biggest reason for this health disparity is access to oral health care for children and adults with IDD: lack of preventive and regular care, including management of secondary medical conditions that are related to oral health, leads to more significant oral health problems. Wait times for IDD specialized services can be as long as a year at practices and dental school programs that offer them.

But Partners Health Plan (PHP), a NY-based health plan that is exclusively dedicated to supporting the health and well-being of individuals with IDD, is committed to ensuring the oral health of its members.

“Improving access to dental care for our community of service in New York State is mission-critical,” added Steven Merahn, MD, Medical Director, Partners Health Plan. “Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

“Our overarching goal is to improve the quality of life of our members and the relationship between oral health and overall well-being is well established.”

Steven Merahn, MD, Medical Director, Partners Health Plan.

To achieve this goal, PHP has partnered with Solvere Health to deploy specialized IDD mobile dental clinics at select-day service locations in Metro New York to reduce travel demands. Solvere Health is a company that specializes in the delivery of high-quality clinical services through group health events via mobile medical units or pop-up clinics to underserved populations. Individuals with IDD may struggle with the sights, sounds and experiences encountered during dental care, and the PHP-Solvere Dental Health Program will conduct specialized desensitization sessions to prepare individuals for the dental care experience and mobile clinic environments. The mobile dental units are also fully accessible for individuals with mobility challenges.

“Expanding the availability of quality healthcare services to underserved communities is central to Solvere Health's mission. We view the collaboration with Partner Health Plan as a way to make quality dental care accessible to persons with I/DD,” stated Edward Lorch, CEO, Solvere Health, “Our mobile clinics offer a solution that is empathetic and considerate. We factor in the patient population's comfort (including desensitization), convenience, mobility, and communication. When engineering and staffing the mobile clinic, we understand that taking a holistic view of the patient leads to a positive oral healthcare experience and repeat preventative care.”

“This mobile dental clinic initiative is a very exciting opportunity as it will open access to oral healthcare,” noted Rita Marie Bilello, DDS, CEO, and former Dental Director of Metro Community Health Centers. “This new dental care model will bridge a much-needed gap for Partners Health Plan (PHP) members, all adults with IDD, who have been unable to access routine preventative oral health care services. Mobilizing dental services will begin to address some of the access issues and will allow for PHP to better assist in getting their members the oral care that they need.”

The first mobile dental clinic for PHP members is scheduled at the PHP corporate headquarters located at 2500 Halsey Street in the Bronx on Saturday, February 18, 2023. Future mobile health clinic locations will include locations in the New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County where PHP operates. PHP welcomes partnerships with local agencies to serve as destination sites for a mobile clinic.

For more information please contact: This email address is being protected from spambots. You need JavaScript enabled to view it..

News organizations that want to attend/cover the first clinic should reach out to Elizabeth Wales, Assistant Vice President, Strategic Communications at This email address is being protected from spambots. You need JavaScript enabled to view it. or by phone at 518-410-5629.

About Partners Health Plan
Partners Health Plan (PHP) is the first-in-the-nation, provider-led managed care organization that fully integrates Medicare and Medicaid for individuals 21 years and older with Intellectual and Developmental Disabilities (IDD), so they have the most complete care package. PHP provides person-centered care for whole-person wellness addressing the physical, behavioral, and social needs of individuals to assist them in living a quality life. The plan operates in 4 New York State regions (nine downstate counties): New York City, Long Island (Nassau and Suffolk counties), Rockland County, and Westchester County. For more information, visit

About Solvere Health
Working with state and federal, institutional, and corporate partners, Solvere Health brings a business discipline to health challenges across the United States through onsite, mobile, and digital healthcare solutions. Deploying a team of highly motivated, accountable problem solvers, we stand up sustainable, end-to-end programs in rapid response to group health events, disaster relief, and underserved rural communities, via onsite pop-ups, mobile clinics, and strategically placed brick-and-mortar locations. Our efficient approach combines exacting strategic planning, comprehensive compliance management, unparalleled logistics, state-of-the-art mobile healthcare technology, and emerging digital health applications.

Message from the Medical Director: COVID-19 & Flu Season

Watch a short video with a message from our Medical Director Steven Merahn, MD, about COVID 19 and Flu season!


Hi, I'm Dr. Steven Merahn, Medical Director at Care Design New York and Partners Health Plan.  

It's Fall, also known as flu season. Unfortunately, at the same time, we're seeing an increase in the number of cases of COVID infection in New York State.  

And while the number of COVID cases remains low, there are some significant increases in the number of hospitalizations and deaths from COVID in individuals who are most vulnerable to severe infection.  

These risk factors for severe infection include advanced age, multiple medical conditions, including heart and lung disease or cancer, history of smoking, and of particular importance here, people with intellectual and developmental disabilities.  

Vaccines are the single most powerful tool we have to prevent severe disease for both flu and COVID. And while the vaccines may not always prevent infection, they are well proven to reduce the risk of severe infection and hospitalization, as well as making your symptoms milder and shorten the course of any infection. 

So, please get your flu vaccine and COVID vaccine as soon as possible. You can safely get them both together. And keep in mind that the new COVID vaccine is not a booster. It's a new formulation designed to protect you against new variations of the virus.  

Other ways to prevent infection include frequent hand washing, use of hand sanitizer, practicing cough etiquette, covering your mouth with a tissue you dispose or coughing into your elbow, and many people are choosing to wear a mask when in public or crowded places. Many health systems are having their professional staff wear masks to protect patients and visitors.  

Flu and COVID share many signs and symptoms in common. This includes cough, runny, stuffy nose, tiredness, fever, muscle aches and pains. 

First, if you start to feel sick, stay out of public places, work, or group programs.  

Second, if you start to feel sick, test for COVID as soon as you can. Early detection of COVID is important and there are medications, one is called Paxlovid, you can take early in the course of an infection that can induce your risk of serious infection. To be most effective, they need to be taken in the first five days of your illness, and that's why early testing is so important. Talk to your doctor or pharmacist about medication once you get a positive test.  

Finally, whether flu or COVID infection, you should always seek medical care if you have trouble drinking fluids, have trouble breathing, or don't have enough breath to finish a sentence, your lips or nails are discolored or blue, your fever doesn't respond to medications, or you're just too sleepy to stay awake during the day.  

I know this was a lot of information, but I hope it helps you have a healthy fall and winter season.  

And thanks for listening.  

For more information, reach out to your Care Manager. 


Message from the Medical Director: COVID-19 Update

Message from the Medical Director

An Update on COVID-19

Dear Members, Families, and Friends,

Over the last few months, a number of new forms (also known as “variants”) of COVID-19 virus have appeared in communities across the United States. This has been associated with an increase in the number of people getting sick, and hospitalized, due to COVID-19 infection. .

While the total number of cases remains low, in New York State the number of positive tests has increased 400% since June. Experts are sure this is the beginning of a wave of infections that will continue to increase into the Fall and Winter.

We are keeping track of this but want to make sure the IDD community remains safe. People with IDD, as well as the elderly, and those with chronic illnesses such as lung disease, cancer, heart disease and others, are vulnerable to severe illness, increased risk of hospitalization, and other consequences of COVID-19 infections.

Let’s make sure everyone – people with IDD and those that care for, and about them - is protected and can protect each other.

FIRST, with vaccines that are well-proven to prevent severe illness

Please get a flu vaccine as soon as possible.  The flu and COVID-19 can “look and act alike” and getting a flu vaccine will protect you from a known health risk every Fall and Winter. Care Managers can help ensure you get all the vaccines needed to protect your health.

There will be an updated COVID-19 vaccine that will be available in the Fall, one that will offer protection against some of the new variants. Even if you have not received a booster in the past, you should get this version.

Finally, if you or your loved one is over 60 years of age, talk to your primary care provider about getting the new vaccine against RSV, a virus that can cause severe lung disease in older adults. Last year the rate of hospitalizations for RSV among adults was 10X higher than usual. The RSV vaccine can be given at the same time as the flu and COVID-19 vaccines.

If you have any questions about vaccines, please reach out to your healthcare provider.

AND, with physical precautions

Handwashing, physical distancing, and mask usage are all well-established, easy to use and well proven ways to prevent spread of all respiratory infections. 

Masking remains a personal choice. However, healthcare professionals are increasingly considering a return to masking as a precaution in healthcare and residential settings, like hospitals and nursing homes.  Some experts are suggesting that caregivers for those who are at risk should consider using masks as well. Healthcare settings like clinics and hospitals are also reinforcing the importance of workers – including healthcare professionals like nurses and aides - staying home if they are sick.

FINALLY, with early interventions

If you find yourself with ‘flu-like’ symptoms like fever, cough, headache, or muscle pain, get tested as soon as possible. If you test positive, have mild to moderate symptoms and are in a high-risk group, you should ask your doctor or pharmacist for a medication called Paxlovid. Paxlovid can reduce hospitalization rates by 80% if taken within five days of symptom onset.

People who are positive for COVID-19 should stay home or isolate themselves for at least five (5) days. 

We will keep track of the trends and any changes in recommendations for prevention and treatment. 

Thanks for your attention,

Steven Merahn, MD
Medical Director


National Enteral Supply Shortage

National Enteral Supply Shortage

Attention Providers who Prescribe Enteral Supplies or Support Members in Need of Enteral Supplies

We would like to provide an industry update as a follow-up to our Winter 2023 Provider Newsletter article concerning nationwide shortages of enteral nutrition supplies. Unfortunately, this shortage is continuing to occur at the manufacturer level..

The largest manufacturers of enteral products (Nestle and Abbott) have advised that shortages may continue through the end of 2023 and into 2024..

We have been monitoring the ongoing shortage and would like to share recommendations on how to manage enteral nutrition needs of the individuals you support to avoid gaps in service.

  • PHP’s DME department would like to remind providers that there are substitute products available from other manufacturers available on the market.
  • A new physician order will be required to transition your patients to an alternate product.
  • Nestle Alternatives
  • Abbott Alternatives

You can reach our DME team by phone at 646-455-1594 and by fax at 646-948-1027.

PHP has an in-house team of DME specialists to assist in ordering Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies for PHP Care Complete FIDA-IDD Plan Participants. If a patient you support needs any DME/POS items, please ensure that a complete script and letter of medical necessity (LOMN) is provided to PHP in a timely manner.