Reminder: Home health care services won’t require prior authorization for Medicare Advantage members, starting Oct. 1

As we announced in a July 2, 2024, provider alert, home health care services for Medicare Advantage members will no longer require prior authorization, starting Oct. 1, 2024.

For claims that are submitted on or after Oct. 1, 2024, our systems won’t look for an approved prior authorization. In addition, we won’t accept retroactive authorization requests.

Our provider manuals and related documents have been updated to reflect these changes.

Reminders:

• As part of our commitment to deliver care in line with standards set by the Centers for Medicare & Medicaid Services, we’ll continue to monitor compliance with these standards through claims review, post-payment audits and strategic collaboration with health care providers who are in shared- and full-risk arrangements.
• Be sure to check each member’s eligibility and benefits prior to performing services.