Medica
Medica will continue to waive prior authorization through
September 30, 2020.
Medicaid - AHCA
(This applies to Florida ONLY)
The Agency has lifted prior authorization for certain critical services for all Medicaid recipients and has lifted prior authorization for all services if the recipient is diagnosed with COVID-19. Please refer to the guidance published by the Agency on March 18th for a list of service categories where the prior authorization requirement has been lifted
.
Clarification: 5.8.2020
Prior Auths: on or after March 1, 2020 through the termination of the emergency declaration for at least
90 days and up to 180 days (up to the last day of the emergency period under Section 1135(e) of the Act),
for beneficiaries with a permanent residence in the geographic area of the public health emergency declared by the Secretary.
PASRR Level 2 exceptions were only in place for 30 days from the date initiated.
Molina
Molina is now requesting SNF's gets prior authorization effective
June 19, 2020.
Preferred Care Partners
Preferred Care Partners is working to reduce administrative work for health care providers. Through
May 31, 2020
, providers will not need to do a prior authorization to move members to a different post-acute setting (i.e., long-term acute facilities, inpatient rehabilitation, skilled nursing facility or home health care). The admitting provider simply notifies us within 48 hours of the move.
Simply
Simply is waiving initial authorization, this provision is applicable to all managed care plan enrollees.
This applies to both in and out of network providers for
90 days from March 17, 2020 expiring June 16, 2020
.
Staywell Medicaid
(This applies to Florida ONLY)
Staywell as of
June 19, 2020
will begin to require authorization for SNF placement.
Sunshine
Sunshine as of
June 19, 2020
will begin to require authorization for SNF placement.
United Healthcare
United Healthcare states normal prior authorization requirements will resume
June 1,2020
.
WellMed
WellMed states normal prior authorization requirements will resume
June 1,2020
.
Update: 6.19.2020
WellMed is extending waiver of prior authorization until July 31, 2020 for in network providers. Out of network providers need to attain prior to admission.
