​​COVID-19 (Coronavirus): Temporary suspension of certain prior authorizations

July 23, 2020

This article was revised on July 23, 2020, to update the suspension criteria and effective timeline.

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.

Temporary suspension of prior authorization during COVID-19 crisis

Effective March 31, 2020, through July 31, 2020, Independence temporarily suspended prior authorization for acute in-network inpatient admissions from the emergency department; transfers from acute in-network inpatient facilities to in-network post-acute facilities and other inpatient facilities; in-network transportation from acute inpatient facilities to subacute facilities; and in-network ambulance transport for any diagnoses.

Beginning August 1, 2020, Independence is modifying the policy to temporarily suspend prior authorization for:

  • Acute in-network inpatient admissions from the emergency department for only COVID-19 diagnoses.
  • Transfers from acute in-network inpatient facilities to in-network post-acute facilities (long-term acute care hospitals, inpatient rehabilitation, skilled nursing facilities) for only COVID-19 diagnoses.
    • Federal Employee Program members are excluded from the prior authorization suspension of transfers from acute in-network inpatient facilities to in-network post-acute facilities.
  • Transfers from acute in-network inpatient facilities to other in-network inpatient facilities and in-network ambulance transport for only COVID-19 diagnoses.

The suspension will last until December 31, 2020. Independence will continue to assess the situation based on COVID-19 activity and share updates with our provider community.

Utilization management

Facilities must continue to notify Independence’s Utilization Management Department within contractual time frames, but no longer than two business days from admission to an acute or post-acute facility.

The Utilization Management and Care Management Departments will collaborate with facilities to gather clinical information and to assist in the coordination of transitions of care for members.

Medical records

Independence retains the right to audit medical records, as warranted.

Learn more

For more information about Independence’s position on COVID-19, please review the following resources: