January 7, 2022
COVID-19 Update: Authorization Process Changes – UPDATE TO PRIOR COMMUNICATION
Together, we are facing one of the most significant and wide-ranging health crises in recent memory. Health Partners Plans (HPP) is always looking for ways to partner with you to support the care of our members.
We are providing updates since our last communication dated December 17, 2021. The below applies to all lines of business managed by HPP and will remain in effect until February 1, 2022.
Effective December 17, 2021:
- Post-discharge of a member to an in-patient skilled nursing facility will not require authorization for the first five days if the transfer is to a HPP participating facility.HPP requires notification within 48 hours of admission. We will require clinical information from the skilled nursing facility on day five for medical necessity review for continued stay (if expected). HPP will coordinate with the post-acute facility to obtain review and authorization for medically appropriate days within the covered benefit.
Effective January 6, 2022:
- In-patient authorizations for all non-elective admissions. Hospitals may elect to delay the authorization process for all (or certain) non-elective admissions. To ensure claims adjudicate properly and timely, HPP will require notification of these admissions. You can continue to submit notifications through the HP Connect provider portal. Certain admissions will be subject to retrospective review for medical necessity.
HPP will coordinate the retrospective review process with each Hospital directly at an appropriate time. There is no need to notify HPP if you elect to delay certain authorizations.
- Post-discharge of a member to an acute rehabilitation facility will not require authorization for the first five days if the transfer is to a HPP participating facility. HPP requires notification within 48 hours of admission. We will require clinical information from the acute rehabilitation facility on day five for medical necessity review for continued stay (if expected). HPP will coordinate with the post-acute facility to obtain review for medically appropriate days within the covered benefit.
We will continue to keep you informed of additional changes, including those required by our regulators, in the coming days and weeks.
For more information, visit HPPlans.com/covid. This page will be continually updated as new information is released by regulators, CDC or HPP. We strongly encourage you to check this site routinely for the most current information regarding our members, plan and employees.