Aetna
(This applies to Florida ONLY)
Aetna will continue to waive prior authorization through August 26, 2020 for Commercial and Medicare Advantage members notification is required within 48 hours of admission.
AvMed
(This applies to Florida ONLY)
No information regarding changes to prior authorization and SNF stays at this time. Auth is still required.
BayCare
(This applies to Florida ONLY)
BayCare Plus Medicare Advantage has temporarily waived the prior authorization requirement for admission to SNF, ARU, and LTACH levels of care. Baycare is requiring notification by the facility that the member is being admitted to and clinical documentation, supporting the reason for transfer. Baycare will follow normal concurrent review process and will continue to follow our members for discharge planning needs. Notification of admission can be submitted by phone or fax. Please note: this only applies to in-work providers, out of network providers should seek authorizations.
CarePlus
(This applies to Florida ONLY)
CarePlus is suspending the prior authorization requirements for in-network providers. This applies to inpatient, outpatient, and all par referrals for all product lines offered by CarePlus. This continues to apply to both in-network and out-of network providers when the member has a COVID-related diagnosis effective until August 15, 2020 notification within 24 hours of admission is still required.
Cigna
Cigna will continue to allow emergent or urgent direct transfers to skilled nursing facilities, without prior authorization until October 31, 2020 for both commercial and Medicare businesses.
Florida Blue
(This applies to Florida ONLY)
Florida Blue Medicare, Commercial, and Affordable Care Act is waiving prior authorization requirements for patients being transferred from inpatient acute hospital settings to post-acute care facilities through September 5, 2020 for both commercial and Medicare lines of business. Please see the attached for further details on notification to the plan.
Freedom Health & Optimum HealthCare
(This applies to Florida ONLY)
Freedom as of July 5, 2020 will begin to require authorization for SNF placement.
Humana
Humana states normal prior authorization requirements will resume August 1, 2020.
Medica
Medica will continue to waive prior authorization through September 30, 2020.