Reminder: The 32BJ Health Fund Centers of Excellence for Bariatric and Joint Replacement Surgery program begins January 1, 2022

As communicated in the November 2021 issue of Provider News, the 32BJ Health Fund has partnered with hospitals and providers in New York, New Jersey, Connecticut, Massachusetts, Pennsylvania, and Florida to implement a Centers of Excellence (COE) Program for Bariatric and Joint Replacement surgeries starting on January 1, 2022.

 

Important features of the program include:

• Coverage for 32BJ members: 32BJ Health Fund plan participants will only have coverage for their bariatric or joint replacement procedures when performed by a COE-participating provider at a COE hospital. Participants will have a $0 copay for the procedure and follow-up care within 30 days. There will be no coverage for bariatric and joint replacement surgeries performed by a non-COE provider or at a non-COE hospital.
• To locate a COE provider and COE hospital: Plan participants may call 32BJ Member Services at (800) 551-3225. Providers may call Empire Provider Services at (800) 676-2583.
• Distance threshold: 32BJ plan participants living within 50 miles of a COE hospital must have their surgery performed by a COE provider at a COE hospital. More than 90% of 32BJ members live within 50 miles of a COE hospital.

 

You can easily identify 32BJ plan participants by the unique prefix on their Empire ID, “ETRBJ.”

 

Any provider looking for more information—particularly anyone currently caring for 32BJ plan participants who may be candidates for bariatric or joint replacement surgery—should call Empire Provider Services at 1-800-676-2583.

 

1487-1221-PN-NY