COVID-19 news & updates
January 21, 2022
MCCFL is receiving information from many of the insurance plans regarding prior authorization processes and other updates related to COVID-19. We will continue to provide this information via email communication. However, for the most recent information, we are recommending you visit the health plan's website or call their provider line. We will also be placing the communications from the health plans on our website. They can be accessed by visiting https://client.mccfl.us/public/ and looking under the tools and resources tab in the Coronavirus folder. As best practice, we still suggest you initiate authorization process prior to admission. Please note that unless specified, out of network status still applies to some of their requirements, please read carefully.
Please pay close attention to the waiver details.
Aetna
(This applies to ALL states - National waiver)
Aetna will continue to waive prior authorization through January 31, 2022  for Commercial and Medicare Advantage members notification is required within 48 hours of admission. Please see the waiver flyer for further direction the plan requests you to follow.

Aetna Better Health of Florida
(This applies to Florida ONLY)
Aetna will continue to waive prior authorization for Medicaid members. Notification is required within 48 hours of admission. Please see the waiver flyer for further direction the plan requests that you to follow. Aetna will provide 14 days’ notice prior to the waiver ending.

Centene - Sunshine & Wellcare
(This applies to Florida ONLY)
Centene will waive prior authorization for Sunshine and Wellcare members only for Medicare and Medicaid lines of business. No end date at this time. Notification is required for admission. Please see the waiver flyer for further direction the plan requests you to follow.

Cigna and Cigna HealthSprings
(This applies to ALL states)
Cigna will waive prior authorization for Medicare Advantage and Commercial members through March 31, 2022. Notification is required within 1 day of admission. Please see the waiver flyer for further direction the plan requests that you to follow. Please note that routine and non-emergent transfers to SNF, AR, and LTACH continue to require precertification, and if a hospital is not at capacity and requiring the need to free up bed space for COVID-19, all of these transfers still require precertification. 

CMS 1135 Waiver

Humana
(This applies to CO, IN, MI states ONLY)
Humana will waive prior authorization. See specific state flyer for end date for Commercial, and Medicare Advantage members. Notification is required for admission. Please see the waiver flyer for further direction the plan wants you to follow. This only applies to in-network providers.

Simply
(This applies to Florida ONLY)
Simply will now waive prior authorization for Medicaid members. Notification is required for admission. Please see the waiver flyer for further directions the plan wants you to follow.

United Healthcare
(This applies to IN, and TX states ONLY)
UHC will waive prior authorization. See specific state flyer for end date for Medicare Advantage, Medicaid and Individual and Group Market health plan members. Notification is required for admission. Please see the waiver flyer for further direction the plan wants you to follow. This only applies to in-network providers.

Medicaid - AHCA
(This applies to Florida ONLY)
  • Reinstatement of Interfacility Transfer Prior Authorization Requirements effective July 1, 2021. Notice
  • Reinstatement pf PASRR and Bed Hold requirements effective July 1,2021. Notice
  • Florida Medicaid COVID-19 Flexibilities ended July 1, 2021. Notice
Please note: Things are changing daily. Please reach out to your liaison if you have questions.
COVID-19 Updates
All of these articles can be found on our portal at MCCFL under tools. We will keep you abreast of this as it pertains to Managed Care.
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