Skip to main content

Coronavirus and the Suspension of Certain Utilization Review Requirements

February 1, 2022

As recommended in New York State Department of Financial Services Insurance Circular Letter No. 1 dated January 6, 2022, Wellcare NY has suspended the following prior authorization requirements for Medicare products:

  • Hospital to Hospital transfer between participating facilities
    • The hospital is expected to use its best efforts to provide notice to Wellcare within 48 hours of the transfer.
    • Please include information necessary for Wellcare to assist in coordinating care and discharge planning.
  • Skilled Nursing Facilities (SNF)
    • Providers will have up to 7 days to notify Wellcare of the admission. 
    • Wellcare will approve the first 7 days of the stay, and will conduct concurrent review for all days beyond day 7.

Wellcare will continue to monitor guidance from New York State.

Contact Us icon

ᎤᏚᎸᏓ ᎠᏍᏕᎸᏗᎢ? ᎠᎭᏂ ᎣᏤᏙ ᏂᎯ ᏳᏰᎵᏗ.

ᎢᏍᎩᏟᏃᎮᏓ ᏂᎦᏓ
Last Updated On: 2/1/2022
On Feb. 21, 2024, Change Healthcare experienced a cyber security incident. Any individuals impacted by this incident will receive a letter in the mail. Learn more about this from Change Healthcare, or reach out to the contact center at at 1-866-262-5342.

×