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Healthfirst Inc.

Medicaid

Dental/ Orthodontic Procedure

Dental Problems

2021

Upheld

Fidelis Care New York

Medicaid

Inpatient Hospital

Cardiac/ Circulatory Problems

2022

Upheld

CenterLight Healthcare Inc.

Medicaid

Inpatient Hospital

Cardiac/ Circulatory Problems

2020

Upheld

AgeWell New York

Managed Long Term Care

Home Health Care

Central Nervous System/ Neuromuscular Disorder

2020

Upheld

Healthnow

Indemnity

Pharmacy/ Prescription Drugs

Central Nervous System/ Neuromuscular Disorder

2019

Upheld

Fidelis Care New York

Medicaid

Pain Management

Orthopedic/ Musculoskeletal

2021

Upheld

Metroplus Health Plan

Medicaid

Substance Abuse: Inpatient

Substance Abuse/ Addiction

2023

Overturned

Healthfirst Inc.

Medicaid

Inpatient Hospital

Digestive System/ Gastrointestinal

2022

Upheld

Oscar Insurance Company

EPO

Pharmacy/ Prescription Drugs

Immunologic Disorders

2022

Overturned

Empire Healthchoice Assurance Inc.

Indemnity

Inpatient Hospital

Cardiac/ Circulatory Problems

2022

Upheld

Empire BlueCross BlueShield HealthPlus

Medicaid

Inpatient Hospital

Respiratory System

2021

Upheld

Metroplus Health Plan

Medicaid

Inpatient Hospital

Ears/ Nose/ Throat

2023

Overturned

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