COVID-19 news & updates
September 17, 2021
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, as waivers are coming to an end.

Aetna
(This applies to AZ, AK, FL, GA, LA, MS, OR, TN, TX, SC ONLY)
Aetna will continue to waive prior authorization through October 4, 2021 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 that you to follow.
Aetna Better Health of Florida
(This applies to FL 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.
Bay Care Plus
(This applies to FL ONLY)
BayCare Plus will waive prior authorization for Medicare members now through October 4,2021. Notification is required. Please see the waiver flyer for further direction the plan requests that you to follow.

CarePlus
(This applies to FL ONLY)
CarePlus will waive prior authorization through September 30,2021. Please see the waiver flyer for further direction the plan wants you to follow. This only applies to in-network providers.
Cigna and Cigna HealthSprings
(This applies to ALL states)
Cigna HealthSprings will waive prior authorization for Medicare Advantage members. 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. 

Florida Blue
(This applies to FL ONLY)
Florida Blue will waive prior authorization for Commercial and Medicare Advantage members and 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.
Humana
(This applies to FL, MS and TX ONLY)
Humana will waive prior authorization through see specific state flyer for end date for Commercial, Medicaid 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.

Molina
(This applies to TX ONLY)
Molina will waive prior authorization through October 31, 2021 for MMP, MA and Marketplace members. Notification is required for admission. Please see the waiver flyer for further direction the plan wants you to follow.

Scott and White
(This applies to TX ONLY)
Scott and White will now waive prior authorization through October 31, 2021 notification is required for admission. Please see the waiver flyer for further directions the plan wants you to follow. This only applies to in-network providers.

Simply
(This applies to FL 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.
Sunshine
(This applies to FL ONLY)
Sunshine will waive prior authorization through September 30, 2021 for specific hospital systems see the flyer here for all lines of business. Notification is required for admission. Please see the waiver flyer for further direction the plan wants you to follow.
United Healthcare
(This applies to SC, and TX - specific regions ONLY)
UHC will continue to waive prior authorization see state specific flier for more details for Medicare Advantage, Medicaid and Individual and Group Market health plan members notification is required for admission. Please see the waiver flyer for further directions the plan wants you to follow. This only applies to in-network providers.

Wellcare
(This applies to FL ONLY)
Wellcare will waive prior authorization through September 30, 2021 for specific hospital systems see the flyer here for all lines of business. Notification is required for admission. Please see the waiver flyer for further direction the plan wants you to follow.
Wellmed
(This applies to TX ONLY)
Wellmed will continue to follow UHC's waiver process and allow waiving prior authorization 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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