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BREAKING: UHC, Cigna Waive Prior Authorizations for Post-Acute Care

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Original story posted on: March 25, 2020

Long-awaited and highly anticipated, providers hope other payers will follow suit.

Healthcare insurer giant UnitedHealthcare (UHC) has announced that it will be suspending prior authorization requirements for post-acute settings through May 31, 2020, with the waiver applying to long-term care facilities (LTCFs), acute inpatient rehabilitation (AIR), and skilled nursing facilities (SNFs).

Cigna has announced a similar waiver, noting on its website that it was making it easier for “for hospitals to transfer patients to long-term acute-care hospitals (LTACHs) and other sub-acute facilities to help manage the demands of increasingly high volumes of COVID-19 patients.” Cigna also said that in place of prior authorizations, it would require notification from the LTACH on the next business day following the transfer.

“This policy will remain in place through May 31, 2020, and applies to Cigna commercial and Medicare Advantage plans,” the announcement read. “Cigna has also waived prior authorizations for the transfer of its patients to other in-network sub-acute facilities, including skilled nursing facilities and acute rehab centers.”

Prior authorization constitutes the utilization management method of earning preapproval for insurance carrier coverage of a prescribed procedure, service, or medication. It is routinely described as ranking among the most arduous issues for providers to work through, with a whopping 83 percent of those reportedly recently surveyed by the Medical Group Management Association (MGMA) describing it as “very” or “extremely” burdensome.

“The ability to quickly move patients along the continuum of care is crucial in this pandemic,” said Ronald Hirsch, MD in an email to RACmonitor. “It is heartening to see UHC and Cigna remove the barriers to efficient transfers, and I am sure that every healthcare provider would urge all other payers to do the same.” 

https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/pa-covid19-updates.html

https://www.cigna.com/newsroom/news-releases/2020/cigna-makes-it-easier-for-hospitals-to-focus-on-covid-19-by-helping-accelerate-patient-transfers?WT.z_nav=newsroom%2Fnews-releases%2F2020%2Fcigna-takes-additional-actions-to-protect-customers-and-communities-against-covid-19;Body;Cigna%20Makes%20It%20Easier%20For%20Hospitals%20To%20Focus%20On%20COVID-19%20By%20Helping%20Accelerate%20Patient%20Transfers

Chuck Buck and Mark Spivey

Chuck Buck is the publisher of RACmonitor and is the executive producer and program host of Monitor Mondays.

Mark Spivey roundMark Spivey is a national correspondent for RACmonitor.com who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for five years.

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