​​COVID-19 (Coronavirus): Suspending prior authorization for acute care

June 26, 2020

This article was revised on June 26, 2020, to update the effective timeline.

Independence is committed to providing our members with access to the care they need. As COVID-19 has escalated into a pandemic, we are working to make sure that our members can receive appropriate testing and treatment for the virus causing COVID-19 if needed.

We encourage all Independence members 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 immediately, Independence is temporarily suspending prior authorization for:

  • Acute in-network inpatient admissions from the emergency department for all diagnoses, including COVID-19.
  • Transfers from acute in-network inpatient facilities to in-network post-acute facilities (long-term acute care hospitals, inpatient rehabilitation, skilled nursing facilities) for any diagnoses.
    • This includes in-network transportation prior authorization requirements from the acute inpatient facility to a subacute facility.
    • 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 any diagnoses.

The suspension will last until July 31, 2020. At that time, we will reassess the situation based on COVID-19 activity.

Utilization management

Facilities must 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: