Some Payers Resume Prior Authorization Requirements
By Ellen Terry

BCBS_ERS

 

Several commercial payers have resumed prior authorization time frames and requirements that had been suspended because of the COVID-19 emergency, while others will continue to approve prior auth requests or suspend them for at least part of the year.

Below is an overview of some payers’ COVID-19 prior authorization policies as of April 2021:

Blue Cross and Blue Shield of Texas ended approvals on services with existing prior authorizations on Dec. 31, 2020. 

Aetna is approving prior authorization requests for commercial and Medicare Advantage members until the end of the plan year. “Authorization may be extended beyond the plan year, for a period of six months, if continued eligibility can be confirmed.”

Cigna resumed standard prior authorization time frames and requirements beginning April 1, 2021. 

Humana resumed standard prior authorization time frames and requirements beginning April 1, 2021.

UnitedHealthcare will not require prior authorization for most services through the national public health emergency period, currently scheduled to end April 20, 2021. Exceptions include medical and behavioral health services, post-acute care admissions, site of service reviews, and transfers to new providers. Prior authorizations for medical and behavioral health were not subject to extension on or after April 10, 2020.

 

 

Last Updated On

April 14, 2021

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Ellen Terry

Project Manager, Client Services

(512) 370-1391

Ellen Terry has been writing, editing, and managing communication projects at TMA since 2000. She hails from Victoria, Texas; has a journalism degree from Texas State University; and loves to read great fiction. Ellen and her husband have two grown sons and a couple of cats.

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