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Payment Integrity Policies

11/17/2025

EmblemHealth is introducing a new Medicaid Benchmark Rate Adjustments Payment Integrity Policy to provide clarity; the policy specifically addresses our system updates based upon New York State Department of Health facility-specific benchmark rate adjustments. 

The following EmblemHealth payment integrity policies have been updated. See their revision histories for effective dates and applicable changes: 

  • Annual Fee Schedule Update.
  • Device, Implant and Skin Substitutes Coding Guidelines (Facilities).

JP70544 11/2025

Provider Update