As we’ve announced in previous issues of Insights and Updates for Providers, Point32Health and Tufts Health Plan will transition administrative operations of the US Family Health Plan (USFHP) to BrightonOne (formerly Brighton Marine) and its subcontractors, effective for dates of service beginning Jan. 1, 2027. 

Providers do not need to resubmit authorizations Point32Health has already approved, including for dates of service on or after Jan. 1, 2027. BrightonOne will honor all authorizations approved on or before Dec. 31, 2026 for dates of service after Jan. 1, 2027 as if those authorizations were approved directly by BrightonOne.

Claims for dates of service prior to Jan. 1, 2027 will be accepted and processed as usual through April 30, 2027. Claims filed after April 30, 2027, or for dates of service on or after Jan. 1, 2027, will be processed by BrightonOne’s claims processing subcontractor, Signature Performance.

As part of USFHP at BrightonOne’s transition to direct provider contracting, BrightonOne is actively engaging practices, medical groups, and health systems regarding participation in the USFHP network.  Providers who have not contracted directly with BrightonOne will need to do so prior to the new plan year in order to remain in-network for USFHP. If your organization has not yet been contacted by BrightonOne/USFHP regarding a direct participation agreement, please contact BrightonOne/USFHP at [email protected] to check your contract status or to begin the direct contracting process and help ensure continuity of participation. 

Providers currently credentialed by Tufts Health Plan Commercial will be accepted as credentialed by BrightonOne through the current scheduled recredentialing date. If you or any individual providers in your practice are not currently credentialed through Tufts Health Plan as part of the USFHP plan offering, BrightonOne will require time to process a credentialing application before adding your practice to the network panel for 2027. Please contact BrightonOne directly for any questions around credentialing for 2027 onward.

BrightonOne will publish further operational updates for USFHP network providers on USFamilyHealth.org/for-providers/ as the transition progresses, including a new Provider Manual, instructions to apply for new credentialing, or ways to update provider demographic data.

Tufts Health Plan Commercial no longer available after Dec. 31, 2026

In the interest of delivering a more unified product for our Commercial markets business, nearly all Tufts Health Plan Commercial members have already transitioned over the last few years to Harvard Pilgrim Health Care Commercial plans based upon employer group and individual plan selection. USFHP was the exception; with the transition of USFHP to BrightonOne, Point32Health’s Tufts Health Plan Commercial line of business will be discontinued and will no longer be offered as a health plan option. 

If you are contracted for Tufts Health Plan Commercial, there is no action you need to take regarding your participation in our provider network. If you are currently in network for any other Point32Health products, you remain contracted and enrolled. We will continue to proudly offer our Harvard Pilgrim Health Care Commercial products, Tufts Health Plan Senior Products, and Tufts Health Public Plans.