EmblemHealth Enhances Patient-Centered PCP Assignment Process Starting January 1, 2024 

EmblemHealth announces a revised Primary Care Provider (PCP) assignment process, effective January 1, 2024. Members enrolled in all Health Maintenance Organization (HMO) products will no longer be automatically assigned to a specific practice within the last two years, nor will they remain attributed unless they actively choose a provider or a claim indicates they have been cared for by a PCP in that practice. 

It marks a departure from the previous policy, which allowed PCPs to retain commercial and Medicare auto-assigned members regardless of direct interaction with these individuals. In alignment with state policy adjustments, Medicaid members will now be automatically assigned to provider groups based on demographic and location needs starting in 2024.