Medicaid Waivers Expiring

Temporary Medicaid Plan Waivers Expiring for Applicable COVID-19 Treatment and Telehealth Services on June 1, 2021

As we continue to address the COVID-19 pandemic, we want to update you on important changes for our Medicaid plans. Last year, we instituted temporary prior authorization waivers for select services to ensure critical care could be quickly delivered to our members during a time of heightened need. On June 1, 2021, these temporary waivers will expire and our members' Medicaid plan benefits will be reinstated for the following services:

COVID-19 Treatment Related Services

• COVID-19 treatment related services (those billed with a confirmed ICD-10 diagnosis code) will continue to be eligible for coverage at this time, in accordance with the member's plan benefits.
• Beginning June 1, 2021, prior authorization will be required for COVID-19 treatment related services, in accordance with CMS guidance and plan benefits.

Servicios de telesalud

• Any services that can be delivered virtually will continue to be eligible for telehealth coverage at this time.
• Beginning June 1, 2021, prior authorization requirements will be reinstated for applicable services delivered via telehealth.
• Los proveedores deben especificar la atención médica de telesalud en su formulario de reclamo siguiendo los protocolos de facturación de telesalud estándares en su estado.
• Para obtener más información sobre los códigos de los servicios de telesalud, recomendamos consultar las publicaciones de los siguientes organismos:
  • Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS)
  • Asociación Médica Estadounidense (AMA)
  • Centers for Commercial/Marketplace and Medicaid (CMS

Prior authorization requirements will continue to be waived for COVID-19 testing, screening services and vaccinations.

We continue to work in close partnership with state, local and federal authorities to serve and protect our members and communities during the COVID-19 pandemic, including ensuring that our providers have relevant and up-to-date information. We value your partnership during these unprecedented times.

Estas directrices se elaboraron como respuesta a la pandemia actual del COVID-19 y es posible que se eliminen más adelante.