Attention: Our Medical Director, Dr. Maulik Trivedi, has authored an open letter to our provider partners, highlighting the critical role of preventative care services for individuals with IDD. This insightful resource offers practical guidance to help you deliver more proactive, person-centered care and improve long-term health outcomes.
Providers
Provider Resources
Important provider resources, forms and guidelines for providers in the Partners Health Plan network.
Billing & Claims
Claims and billing submission guidelines, contact information, and other billing and claims resources
Authorizations & Appeals
Authorization requirements, request forms, and appeal / greivance information.
Important Provider Updates
Providers, please read this important announcement regarding Dental Services effective January 1, 2025.
Provider Events & Webinars
Previous Provider Webinars
May 14, 2025 Provider Webinar - Trauma Informed Care
Our Trauma Informed Care Webinar provides information on trauma types, how to recognize the signs and symptoms that someone may have experienced a traumatic event, and person-centered ways to support someone who has experienced a traumatic event. This training also discusses resources that can be utilized to access Trauma Informed Care.
PRESENTED BY: Melissa Ackernecht, Behavioral Support Specialist; Trisha Chapman, Director of Specialized Services; Brittany Miske, Vice President of Healthcare Management and Clinical Support
Supporting Documents:
February 12, 2025 Provider Webinar - Winter Cardiovascular Wellness
Cardiovascular conditions are commonplace for many individuals with IDD. Add the stress of winter weather and you have the perfect storm for complications. In this webinaryou will learn about the effects of cold weather on CV disease and individuals with IDD.
PRESENTED BY: Brittany Miske, Vice President of Healthcare Management and Clinical Support
Supporting Documents:
November 20, 2024 Support Broker Training - Staying Healthy & Independent
In this webinar you will learn how to best help individuals in Self-Direction, and those that support them such as their Brokers, Family Liaisons, families, and other team members maintain wellness and connected to our community. This program will assist with better understanding that we are all just one adverse health event away from losing some of our independence and having to make significant changes to our lifestyle. The discussion focuses on the importance of self-advocates to take charge of their health, to participate whenever possible, to understand their wellness journey, and to plan for the future. Examples will be provided on a whole-person care model that is built to assist individuals to remain healthy, avoid hospitalizations, and stay in the environment of their choice.
PRESENTED BY: Karleen Haines, Chief of Advocacy; Annrose Bacani, Director of Outreach and Enrollment
October 23, 2024 Supported Decision Making — A Less Restrictive Alternative to Guardianship
In this virtual presentation, join Supported Decision Making-NY Associate Director Joan Cornachio in a conversation to learn how supported decision-making is an effective process for many individuals on the spectrum and with other developmental disabilities in New York, as they strive for more inclusive and self-determined lives. The presentation will explain how the SDMNY facilitation process works and the role and responsibilities of Supporters. An overview of the impact of the SDMA law will also be covered.
PRESENTED BY:Joan Cornachio,Supported Decision Making-NY Associate Director
September 25, 2024 PHP Quality Initiatives Provider Webinar
Learn how Partners Health Plan (PHP) and Providers can collaborate together to assist members with IDD achieve quality of health outcomes. This webinar will discuss key Quality of Health initiatives implemented for members enrolled with PHP. Join our webinar to learn more about the following:
- HEDIS Quality Measures
- Medical Record Documentation
- CAHPS Survey
- Health Outcomes Survey
- Transitions of Care
- Quality Improvement Programs
PRESENTED BY: Premila Kumar, Chief of Quality Initiatives; Diane Marrone, Chief of Care Management
September 16, 2024 Support Broker Webinar: Guardianship
For those supporting and advocating for individuals with intellectual and/or developmental disabilities (IDD), understanding the guardianship process is crucial.
In our upcoming Support Broker training, Giselle Peter, Regional Care Manager Director for Partners Health Plan, and Lisa Miller, Care Manager Director for Care Design NY, will provide an in-depth overview of guardianship, including what it is, how it functions, and why it may be necessary.
This presentation is designed to give you deeper insight into the legal procedures for establishing guardianship and the various types of guardianship that exist under New York State law. We'll also cover best practices for supporting people under guardianship arrangements, providing you with the expertise you need to help individuals with IDD and their caregivers navigate the process.
PRESENTED BY: Giselle Peter, Regional Care Manager Director for Partners Health Plan & Lisa Miller, Care Manager Director for Care Design NY
July 23, 2024 Provider Webinar: Whose Life Plan is it Anyway? - Collaborative Best Practices for Life Plan Develop
In this webinar, we share Care Management best practices for ensuring providers are engaged and your valuable input is included in individuals’ Life Plans. Care Design NY and Partners Health Plan’s Care Management teams review the collaborative Life Plan process and the connection between the Life Plan and Staff Action Plan.
PRESENTED BY: Danielle Mazza, AVP of Care Management for Upstate NY; Ernie McNutt, AVP of Care Management for Downstate NY
Supporting Documents:
April 25, 2024 Provider Webinar: Medicaid Eligibility: Maintaining Benefits for the Intellectually and Developmentally Disabled in New York State
This webinar was in collaboration with Care Design NY and focused onchanges to Medicaid eligibility and recertifications, as well as the unwinding of the Public Health Emergency (PHE) as it relates to Medicaid coverage.
PRESENTED BY: Kristina Cunningham, Assistant Vice President of Member Benefits and Enrollment
Supporting Documents:
Webinar Slides | 2024 Maximum Monthly Benefit Amounts | 2024 SSI and Personal Allowance Amounts | MAGI and Non-MAGI Income Standards
October 26, 2023 Provider Webinar: Best Practices for IDD-Tailored Medical Care
This webinar was The webinar was in collaboration with Care Design NY, and focused on how individuals with Intellectual and Developmental Disabilities (IDD) have unique patterns of health-related risks and conditions and how they can benefit from some distinct approaches to annual wellness and healthcare maintenance. Based on a review of the literature, this presentation summarized some practical approaches to supporting and improving the quality of health of those with IDD.
PRESENTED BY: Stephen Merahn, MD, Medical Director
August 22, 2023 Provider Webinar: Medicaid Eligibility: Maintaining Benefits for the Intellectually and Developmentally Disabled in New York State
This webinar was in collaboration with Care Design NY and focused onchanges to Medicaid eligibility and recertifications, as well as the unwinding of the Public Health Emergency (PHE) as it relates to Medicaid coverage.
PRESENTED BY: Kristina Cunningham, Assistant Vice President of Member Benefits and Enrollment
Supporting Documents:
Webinar Slides | Qualifying Expenses - Spenddowns | 2023 Spenddown Calculation Example | 2023 SSI and Personal Allowance Amounts | 2023 Federal Poverty Level Guidelines
June 14, 2023 Provider Webinar: Medication Related Risk in the IDD Population
This webinar was in collaboration with Care Design NY and focused on:
- Medication Risks for the IDD Population
- PHP’s clinical pharmacy program
- Comprehensive Medication Therapy Reviews (CMTRs)
- What is a CMTR and how it is used
- Clinical Pharmacy program outcomes
PRESENTED BY: Scott Doolan RN BSN, MBA, Assistant Vice President of Health Care Management
March 22, 2023 Provider Webinar: What is IDD Care Management and What Does It Mean To Me?
This webinar was in collaboration with Care Design NY and focused on how Care Management is different when in support of someone with an Intellectual or Developmental Disability (IDD) and the importance of collaboration between IDD Care Managers and the provider community.
PRESENTED BY: Steven Merahn, MD, Medical Director
February 24, 2022 Provider Webinar in Collaboration with Care Design NY: The Life Plan Process
This webinar reviewed the CDNY & PHP alignment, the Life Plan process, the CDNY and PHP escalation process, and how to ensure effective communication and timely resolution.
October, 26, 2021 Provider Webinar: Important Billing and Claims Updates and Reminders
This webinar reviewed Partners Health Plan’s Care Management model, the Life Plan, and important billing and claims reminders, how to appeal a claim denial and timely filing guidelines.
Provider News, Updates & Announcements
Stay up-to-date on important information for providers in the PHP Provider Network.

Ackeem Duggan Discusses Disability Voting Rights In Interview with CBS News New York
October 21, 2024
In the News
Self-Advocate, Ackeem Duggan, Discusses the Power of Voting for IDD and His Work as a…

Veronica Crawford Interview New York Public Radio
September 16, 2024
In the News
Self-Advocate, Veronica Crawford, Discusses Why Voting Matters for People with IDD on…

Message from the CEO: Juneteenth 2024
June 11, 2024
Message from the CEO
Celebrating Juneteenth 2024
Dear Members, Families, and Friends,
Across t…
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