May 2022 Provider Newsletter

We are excited to share that Dr. George E. Matthews has joined Monroe Plan for Medical Care as our new Chief Medical Officer. Along with a wealth of clinical and leadership experience, Dr. Matthews brings a career long commitment to community health naturally affiliating him with Monroe Plan’s mission to serve the underserved.
Dr. Matthews has practiced as a cardiologist in Western New York for the past 35 years. Building on a philosophy that the effective practice of medicine is an art as well as science, he has been driven to improve the quality of life for his patients by providing the highest quality of care.

Democrat & Chronicle Top Places to Work 2022

Monroe Plan for Medical Care is a 2022 Rochester Democrat and Chronicle Top Workplace Winner

Top Work Place Award

April Provider Newsletter 2022

The death rate for Blacks/African Americans is generally higher than whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide.

American Indians/Alaska Natives also have a high prevalence and risk factors for mental health and suicide, unintentional injuries, obesity, substance use, sudden infant death syndrome (SIDS), teenage pregnancy, diabetes, liver disease, and hepatitis.

Puerto Ricans have a low-birth-weight rate that is almost twice that of non-Hispanic whites. Also, Puerto Ricans suffer disproportionately from asthma, HIVAIDS and infant mortality. Mexican Americans suffer disproportionately from diabetes.

Ensure your practice engages in cultural competency training on an annual basis.
Cultural literacy leads to better engagement and connection to care providers.

Provider Newsletter – March 2022

MARCH IS COLON CANCER AWARENESS MONTH – 60% of Colon Cancer deaths could be prevented with screening.

Monroe Plan for Medical Care is proactively outreaching your patients who are turning age 50 in 2022 to educate them on colon cancer screening and, if applicable, ordering Cologuard tests. Please speak to your patients and let them know their options for screening. A FIT or gFOBT test is better than no test at all! The CDC offers a brief description of each test type to educate patients while encouraging them to consult with their physician about which test is best for them.

Provider Newsletter – February 2022


Heart disease is a leading cause of death for both men and women in the United States. Most middle-aged and young adults have one or more risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol, or being a smoker or overweight. Having multiple risk factors increases the risk for heart disease.
• Ensure your patients know their blood pressure and are treated accordingly
• Ensure cholesterol is monitored
• Discuss lifestyle choices/barriers: diet, stress, smoking, access to medications
• Refer patients who need extra support to specialists; endocrinology, nutritionists, mental health support, NYS quit line.

To link patients to support, contact Monroe Plan’s case
management department at or
speak to your MP Quality Representative. To learn more, visit:

Provider Newsletter – January 2022


Thank you to the 117 practices that participated in our IPA Satisfaction Survey. Of the practices that regularly use Monroe Plan services, approximately 90% indicated they are satisfied to highly satisfied. The survey indicates a high level of interest in Monroe Plan’s:
• Outreach to patients to help address gaps in care and other health disparities
• Coding Support and Education
• Contracting and Revenue Management Support (e.g., Provider-Plan contract reviews, Value-based Contract negotiation, Revenue cycle management)

Provider Newsletter – November 2021


On Monday, November 1 a brief satisfaction survey was sent via email to each practice. Please take a few moments to let us know how effectively we are supporting your practice, as well as what additional help your team needs. The email is from Monroe Plan for Medical Care . Your insights will help us tailor services that meet your needs. Thank you in advance for your feedback!

Provider Newsletter – October 2021

October is National Breast Cancer Awareness Month

According to the American Cancer Society, approximately 1 in 8 women (13%) will be diagnosed with invasive breast cancer in their lifetime and 1 in 39 women (3%) will die from breast cancer. Early detection of breast cancer by mammography reduces the risk of breast cancer death and increases treatment options, including less extensive surgery and/or the use of chemotherapy with fewer side effects, and sometimes, the option to forgo chemotherapy.

Provider Newsletter – September 2021


World Suicide Prevention Day is observed each year on September 10. It’s a growing problem and the numbers tell a shocking story. Every 40 seconds someone takes their own life according to the World Health Organization (WHO). Suicide is the leading cause of death for people aged 15 to 29 and for every suicide that results in death, there are as many as 40 attempted suicides. Health Care providers are in a unique position to help address this mental health crisis which has only been exacerbated by COVID-19. If you are concerned about a patient’s state of mind, you might ask:
1. How have you been?
2. How’s your stress level lately?
3. Have you been eating and sleeping?
4. Is there anything you want to talk about?
5. Would you be willing to talk to someone?
6. What can I do for you?

National Suicide Prevention Month and Suicide Resource Center are two excellent resources for additional information. If the patient is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

Provider Newsletter – August 2021


The pandemic has significantly impacted routine vaccination rates, putting people of all age groups at risk for contracting preventable diseases. Your guidance makes a difference! Your recommendation is the number one reason your patients choose to vaccinate on time. Please consider using a presumptive approach that assumes most parents will choose to vaccinate their child. For example, say: “Your
child needs these vaccines today,” instead of “What do you want to do about vaccination today?”. Also, when recommending HPV vaccine, it’s important to recommend the vaccine the same way and same day that you recommend other vaccines for adolescents.

Provider Newsletter – July 2021


Check out MPMC’s new provider portal feature that makes it easy to quickly view your practice’s quality dashboard and ranking. Value added features include reports that identify high utilizers and gaps in care. Data can also be downloaded to excel. Log in to explore this user friendly practice management tool today!

Provider Newsletter – June 2021

Free Online Course, Earn CME’s Monroe Plan, in conjunction with the Rochester Academy of Medicine, is offering a free 3-hour online Continuing Medical Education (CME) Program for “Medical Assisted Treatment for Opioid Use Disorder.” This program is funded by a grant from the Substance Abuse and Mental Health Services Agency (SAMHSA) and is also accessible through the Monroe Plan website.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Medical Society of New York (MSSNY). The Rochester Academy of Medicine is accredited by the Medical Society of New York (MSSNY) to provide continuing medical education for physicians.

Provider Bulletins

Effective November 1, 2021, Molina Healthcare of NY (“Molina”) will be using a new vendor to manage its vision benefit for members enrolled in its Medicaid Managed Care, Essential Plan, HARP, and Child Health Plus products. The name of the new vendor is Superior Vision.

Click here to download: Superior Vision – Molina Provider Notice 11/2021

Please download the Coding crosswalk for claims submission for guidance

Click here to download

Effective for dates of service on or after October 15, 2020 note the coding changes required for claims processing as it
relates to PT, OT and ST services rendered to Molina Health Plan members.

Click here to download: PT, OT, ST Coding Changes Notice

This notice tells you about this upcoming change Please read this notice carefully and save it for future reference.

Click here to download: Pharmacy Carve Out Member Letter Notice

You can also access this notice at:

Effective July 1, 2020, YourCare Health Plan’s Medicaid Managed Care, HARP, Essential Plan, and Child
Health Plus transitioned to Molina Healthcare of New York, Inc. Concurrently, Monroe Plan for Medical Care and affiliated entities entered into an agreement with Molina to provide network management and care management services.

Click here to download: Monroe Plan – Molina Fact Sheet

Network Compliance

Cultural Competency Training for Monroe Plan IPA Providers

Mainstream Medicaid Managed Care Providers are required to ensure the cultural competence of practice staff and to certify annual completion of New York State approved cultural competence training curriculum. The approved training, titled Think Cultural Health, offers several provider specific programs online, at no cost: Providers and appropriate staff should complete this training in the next 12 months and annually thereafter. Once finished, please share your certificate of completion with us at
Be sure to review the bulletin and resource below to ensure cultural competency and compliance!

Click here to download: NYSDOH Cultural Competency Notice

Click here to download: Are You Culturally Competent?

To be sure your practice is accurately represented in Molina’s (MHNY) Provider Directories, you will want to regularly submit updated rosters to

Thank you for your cooperation!

Click here to download

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