Aetna
(This applies to ALL States)
Effective 2.15.2021 through Feb. 28, 2021 Aetna is temporarily making changes to the requirement for prior authorizations for post acute care facilities including SNF's. Initial pre-certification/prior authorization for admission to SNF is being waived for all Commercial and Medicare Advantage Plans. SNF's will be required to notify Aetna of the admission within 24 hours of admission either through Availity, or by calling Aetna directly. SNF's are also required to send medical records for concurrent review within three days of the initial admit. Medical records can be uploaded directly to Availity, or sent to Aetna by fax. Be sure to include patient name, and member ID on your fax cover sheet. Please note: there has been no clarification as to whether or not this applies to both in and out of network providers.
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 states normal prior authorization requirements will resume December 31, 2020.
CarePlus
(This applies to Florida ONLY)
CarePlus states normal prior authorization requirements will resume August 16, 2020.
Cigna
Cigna will waive prior authorizations through March 31. 2021 for the transfer of its non-COVID-19 customers from acute inpatient hospitals to both in-network and out of network providers - LTACH's, SNF, and AR. In place of prior authorizations, Cigna will require notification from the post-acute care provider on the next business day following the transfer.
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 Feb. 28, 2021 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 Health is closely monitoring COVID-19 developments and what it means for our customers and our healthcare provider partners. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention (CDC) to help us determine what action is necessary on our part. We are not waiving prior authorizations at this time.
Humana
(state specific information below)
For Indiana and Texas: Humana is suspending authorization requirements for skilled nursing facilities (SNFs) and long-term acute care (LTAC) for Medicare Advantage and commercial members through February 28, 2021 for in-network providers.
Medica
Medica will suspend prior authorization for admission to a post-acute care setting through April 30, 2021.