This article was revised on December 21, 2021, to update the coverage position.
Independence has temporarily suspended prior authorizations requirements for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, inpatient rehabilitation, skilled nursing facilities) for Commercial and Medicare Advantage members with any diagnosis. This includes ambulance transport for Commercial and Medicare Advantage members. The temporary suspension is effective December 21, 2021, through January 31, 2022. Independence will continue to evaluate the need for this temporary suspension and will extend if needed.
Please note the following:
- Medicare Advantage members are able to transfer to out-of-network facilities as well.
- Prior authorization requirements remain suspended for CHIP members through the end of the federal Public Health Emergency.
These steps are intended to facilitate and reduce administrative processes for the placement of COVID-19 patients to the most appropriate care settings. Notification from facilities is still required.
Facilities must continue to notify Independence's Utilization Management (UM) department within contractual time frames, but no longer than two business days from admission to an acute or post-acute facility.
The UM and Care Management departments will collaborate with facilities to gather clinical information and to assist in the coordination of transitions of care for members.
Independence retains the right to audit medical records, as warranted.
Independence is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all Independence members and providers to visit our dedicated COVID-19 webpage regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.