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HealthChoices Expansion Continuity of Care Process

Health Partners Plans (HPP) would like to make you aware of our approach to improving access to care and overall patient experience for the HealthChoices (HC) expansion effective September 1, 2022. The changes identified below are specific to members who require Continuity of Care in their transition to HPP.

  • Exiting HC plans are required to identify Continuity of Care patients/members (which includes members that have an approved authorization after the transfer date).
  • All HC plans received a list of new members that are being transferred from exiting HC plans.
  • Given the tight Pennsylvania Department of Human Services (DHS) timeframe and the potential for data issues, HPP will be implementing the following plans to mitigate potential disruption:
    • For Continuity of Care patients identified by exiting HC plans (as defined by Medical Assistance Bulletin 99-03-13 and 99-96-01) that become HPP members, HPP will waive all medical prior authorization requirements for purposes of claims payment. These claims will be adjudicated and paid as if an authorization had been obtained as follows:
      • ADULT MEMBERS AGE 21 AND ABOVE: This waiver will be in effect for dates of service 9/1/22 through 10/31/22 (60 days); HPP will monitor the need for any extensions to this process.
      • MEMBERS UNDER THE AGE OF 21: This waiver will be in effect for dates of service  approved by the exiting HC plan, which was provided to HPP on the Continuity of Care file.
      • Providers who have an active authorization on file from the exiting HC plan for members who require Continuity of Care will be required to obtain a new authorization with HPP for services beyond 10/31/22.

If you have questions or need help, please feel free to contact the HPP Provider Services Helpline at 1-888-991-9023.                

We look forward to working with you in providing the highest quality of care to our members.