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Medicare Authorization Flexibilities: Effective January 11, 2022

Medicare Authorization Flexibilities to be implemented January 11, 2022 through January 31, 2022

Inpatient Admissions: We will allow notification of admission up to 5 days post admission date and complete medical necessity reviews when notification is received.

Post-Acute Accommodations for rehab hospitals and Long-Term Acute Care hospitals (LTACH): We will relax our requirements related to facility transfers including:

  1. We will not require discharging acute care facilities to obtain prior authorization for patient transfers to participating post-acute facilities.
  2. We will not require sending facilities to provide notification of transfer to participating providers.
  3. However, we will require receiving facilities to notify the health plan of patient admission. And we will accept notification up to five days post-transfer.
  4. We will continue to conduct medical necessity review
  5. Because we will not have visibility prior to transfer, we request that hospitals utilize our in network post-acute facilities

Skilled Nursing Facilities: We will allow post admission notification and authorize up to a 7 day stay before medical necessity continued stay review.

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Last Updated On: 1/31/2022
On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.