June 2026

When it comes to going to the doctor, many men would rather mow the lawn, clean the garage or go shopping with their spouse or partner. In fact, according to U.S. health reports, men are 24% less likely* than women to have visited a doctor in the past year. 

To help raise awareness about the importance for men to get the medical care they need, June is Men’s Health Month, with International Men’s Health Week during June 15 and 21, in support of improving the health and well-being of men and boys in all phases of life.

Men’s Health Network has announced this year’s national theme, “Partners in Care: Advancing Men’s Health Through Connection, Education, and Advocacy—For Better Lifespans Across the Lifespan,” which emphasizes that men’s health does not happen in isolation. Health outcomes are shaped by relationships with partners, families, caregivers, workplaces, and communities, and strengthening these care partnerships is essential to improving long-term outcomes.

Men continue to experience higher rates of preventable illness and premature death. In the U.S., men die on average 6 years earlier than women, often from conditions that are preventable or manageable with early detection and consistent care. This gap underscores the importance of education, awareness, and proactive engagement.

Men’s health awareness includes, but is not limited to:

• Heart disease and stroke, leading causes of death among men
• Prostate and testicular cancers, where early detection improves outcomes
• Colorectal and lung cancers, which disproportionately impact men
• Diabetes and metabolic conditions, often linked to preventable risk factors
• Mental health challenges, depression / suicide, where men face higher mortality rates
• Substance use disorders, contributing to preventable deaths
• Workplace-related injuries and safety concerns
• Healthy aging and chronic disease management across the lifespan

Improving men’s health outcomes requires a comprehensive approach that promotes preventive screenings, early intervention, mental and emotional well-being, and open health conversations. It also requires recognizing men not only as patients, but as caregivers, partners, fathers, mentors, and community leaders.

“Supporting men’s health strengthens families and communities,” said Jennifer Thompson, VP at Men’s Health Network. “By recognizing care as a partnership, we can encourage earlier conversations, proactive health decisions, and better outcomes for everyone.”

By advancing connection, education, and shared advocacy, we can help close the Lifespan Gender Gap and support healthier, longer lives for men and boys.

For more information and for available resources, visit the official Men’s Health Month site, including its social media toolkit.

According to a 2026 report by the Alzheimer’s Association, the number and proportion of Americans with Alzheimer’s or other dementias is expected to continue to grow because of the growing population of people aged 65 and older.  In fact, more than seven million Americans are living with Alzheimer’s.

The Alzheimer’s Association defines Alzheimer’s and dementia:

• “Dementia describes a group of symptoms associated with a decline in memory, reasoning or other thinking skills.”
• “Alzheimer’s is a degenerative brain disease that is caused by complex brain changes following cell damage. It leads to dementia symptoms that gradually worsen over time.”

10 Early Signs and Symptoms of Alzheimer's and Dementia

Assess patients for signs and symptoms. Early detection can improve quality of life for your patients and their loved ones and caregivers. Ten early signs and symptoms of Alzheimer’s and Dementia are:

1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Help, support and educational resources are available. View these resources for your practice and your patients. 

Health care providers play a critical role in eliminating preventable maternal morbidity and mortality. That’s why Independent Health has created an evidence-based Maternity toolkit to assist you with educational content, tools, and resources. 

The risk of pregnancy-related complications continues for one year after a pregnancy ends. It’s crucial for any health care professional to identify patients who are pregnant or who were pregnant in the last year and to be aware of the urgent maternal warning signs from complications.

Always Ask if Your Patient Is Pregnant or Was Pregnant in the Last Year

Pregnancy or postpartum status may not be something your patient or their support thinks about sharing, particularly with their primary care physician, but it could be the difference in making an accurate and timely diagnosis.

According to the Centers for Disease Control and Prevention (CDC), some warning signs include:

• Severe headache
• Dizziness or fainting
• Changes in vision
• Fever
• Trouble breathing
• Overwhelming tiredness           
• Chest pain
• Severe belly pain
• Severe nausea and vomiting
• Severe swelling
• Thoughts about harming self or baby

Immunizations and vaccinations

American College of Obstetrics and Gynecology (ACOG) clinical guidelines recommend:

• All people who are pregnant during the fall and winter respiratory illness season should receive annual influenza and COVID-19 vaccines.
• All eligible pregnant patients who meet criteria should receive the RSV vaccine.
• All pregnant people should receive a Tdap (tetanus, diphtheria, and pertussis) vaccine during each pregnancy, as early as possible in the 27-to-36 gestational-week window.

OB/Gyns may recommend other vaccines during pregnancy depending on the patient’s age, prior immunizations, comorbidities, and disease risk factors.

View additional information for pregnant patients here.

Important reminders:

• Always discuss immunization status.
• Screen patients for depression utilizing an evidenced-based, validated screening tool (ex: PHQ2/9), and refer to a Behavioral Health Specialist, if the patient has a positive screen.
• Ensure linkage with an Obstetrician or Nurse midwife for early prenatal care, if pregnant.
• Perform a medication review and assess for potential contraindications.
• Document pregnancy information and any referrals made.

Our Maternity Toolkit is posted in the secure provider portal under the Resources Tab in the Maternity Care Resources section. 

Need Help?

To assist you in helping patients manage uncontrolled chronic diseases or for care coordination needs, please call (716) 635-7822 from Monday – Friday, 8 a.m. – 5 p.m. and one of our Care Managers will assist.

Helpful Resources

Urgent Maternal Warning Signs Educational Materials | HEAR HER Campaign | CDC

Dietary Guidelines for Americans | Food and Nutrition Service

Administering the Patient Health Questionnaires 2 and 9 (PHQ 2 and 9) in Integrated Care Settings

The 2026 Clinical Practice Guidelines (CPG’s) have been reviewed and approved by Independent Health’s Quality Performance Committee and updated, where necessary, as of May 21, 2026. Changes include updates/adoption of the following guidelines:

• Changed immunization schedule guidelines to The American Academy of Family Physicians (AAFP) 2026 and the American Academy of Pediatrics from CDC.
• Reiterated these guidelines are researched and rooted in science; contains no changes to AAP’s recommendations for routine vaccines.
  • Adult Immunization Schedule
  • Pediatric Immunization Schedule

Prostate Cancer – Early Detection and Localized Disease (2026)

• Updates emphasize risk adapted PSA screening, shared decision making, increased use of MRI and biomarkers prior to biopsy, and broader adoption of active surveillance for low-risk disease.
• These changes reduce overtreatment, prevent avoidable complications, and support equitable, value-based screening strategies. 
• View these guidelines.

Standards of Care in Diabetes | American Diabetes Association

• Recommendation 1.1 was revised to highlight the importance of shared decision making based on individual values, preferences, prognoses, comorbidities, and informed financial considerations. Recommendation 1.5 was updated to emphasize the importance of continuous quality improvement by health systems to improve quality of care and health outcomes.
• Recommendation 1.8 was revised to include consideration of digital self-management tools or coaches as appropriate to provide support for people with diabetes.
• Recommendation 1.9 was modified to highlight the important role of community health workers in supporting the management of kidney disease risk factors, in addition to diabetes and cardiovascular disease risk factors, in underserved communities and health care systems.
• Table 1.1 was enhanced to specify additional care team members whose expertise may be beneficial for older adults with diabetes.
• View these guidelines.

WNY Collaborative Prenatal Care Guidelines

• Hepatitis C added to initial visit section and added the Adult Immunization Schedule to references.
• View the new guidelines here.    

New Guidelines:

• Cardiovascular-Kidney-Metabolic (CKM) Syndrome

Gaps in Care Correction allow for submitting medical record documentation to “close gaps” for deficiencies in quality measure results due to a variety of reasons, including:

• Encounters or lab values not available to the health plan;
• Exclusions from a historical event (e.g., mastectomy);
• Service that was rendered under a different payer.

The Gaps-in-Care Correction process is not a “replacement” for the normal claims process and practices should not focus on submitting documentation for services that were just rendered recently. 

If Independent Health accepts the documentation submitted, the correction should be reflected in an update to your, and Independent Health’s, quality rates, which allows for:

• A more accurate depiction of the quality of care that was rendered;
• More accurate quality program reporting;
• More targeted quality improvement effort.

Online Resources

• View the Gaps-in-Care Correction Process User Guide for more information about how to submit corrections.  To view the document, enter "Gaps in Care" as a search term in Document Manager.
• View Correctable Measures for 2026. Enter “Correctable Measures” as a search term in Document Manager.
• View a webinar about the Gaps in Care Correction Process.

The last day to submit Gaps-in-Care Corrections for 2026 is Thursday, December 31, 2026.

For more information on all the Measure Year 2026 measure changes, please visit the HEDIS Provider Guide and Reference Manual which is now posted under the Policies & Guidelines menu item in the provider portal. 

If you have questions about the gaps in care correction process, performance reports or anything related to our provider portal:

• Contact your Independent Health Physician Engagement Specialist
• Email ProviderPortal@independenthealth.com

In 2027 there will be a complete overhaul of the maternal care billing codes and guidelines nationally. Due to the timing of the change and the fact that some maternal care will span across the 2026 and 2027 calendar years there is a need to make urgent billing changes for antepartum care services in 2026 to achieve a smooth transition to the new code set in 2027.

As mandated by NYS Medicaid, Independent Health must require providers to submit routine antepartum care visits under the Evaluation and Management codes (ex. 99202-99215) with Modifier TH for members initiating antepartum care on or after June 1, 2026, and/or who have an expected delivery date on or after January 1, 2027 for all State Products. 

Independent Health will apply this billing requirement on June 1, 2026 for all products (Commercial, Medicare, State Programs, and Self-Funded) to ease the administrative burden for our provider community, instead of having different start dates for this transition.

For members initiating antepartum care on or after June 1, 2026, antepartum care codes 59425 and 59426 will no longer be reimbursable for antepartum services; if submitted, the claim line will be denied. Providers must submit each prenatal visit using the appropriate level E/M code, in accordance with current E/M billing guidelines, with Modifier TH appended and a pregnancy-related diagnosis code.

Independent Health is currently making applicable updates to our maternal care reimbursement policies to support this change and will have a section dedicated to this change within the Participating Provider Reimbursement Manual on your provider portal as of June 1, 2026, including billing examples and links to information about the overall coding updates for 2027.

Key Highlights:

• Changes are required for billing antepartum care services for members initiating antepartum care on or after June 1, 2026, with an expected delivery date on or after January 1, 2027
• Applicable to all Lines of Business as of June 1, 2026
• Routine antepartum visits billed with E/M code with a TH modifier.
• E/M visits outside of routine antepartum care are billed without Modifier TH
• Ensure Modifer TH is used appropriately as it may impact claims processing
• Submit 0500F (Category II code) on the initial antepartum visit claim
• Submit the appropriate pregnancy-related “O” or “Z” ICD-10 diagnosis code

If you have any questions, please contact Provider Relations at 716-631-3282 Monday through Friday from 8 a.m. to 5 p.m.

Independent Health develops outreach campaigns to members in need of certain preventive services and to help make them aware of our programs and resources to help them maintain or improve their health. Here is a summary of the current outreach campaigns underway. 

As a result of updates by New York State Medicaid, Independent Health now covers the following code as of April 1, 2026:

To ensure compliance with standards established by New York State for our participating providers, Independent Health has engaged with the firm Press Ganey to conduct brief surveys by phone regarding appointment access and availability for our members.

Important updates have been added to the Participating Provider Reimbursement Manual regarding new claim edits sourced from National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) for our Medicare member claims. 

Providers create strong, evidence-based treatment plans for complex patients. Yet even the best plans can fall short if they are not understood, tolerated, or fit into a patient’s daily life. Independent Health’s Medication Therapy Management (MTM) program helps bridge this gap. We work with patients and providers to ensure therapies are effectively implemented. MTM focuses on supporting success, not re-evaluating clinical decisions.

Dapagliflozin, the generic version of Farxiga, offers a clinically appropriate and cost-effective alternative for many patients. While it is a direct substitution for those taking Farxiga, dapagliflozin may also be considered in place of other higher-cost medications.

Remember to view our up-to-date policies online.