State Waives Medicaid Transportation Rule

Days after agreeing to waive rules that require hospitals to obtain prior authorization before transferring patients to long-term care facilities, state Medicaid officials took another step to try to expedite moving patients out of hospitals amid the surge in COVID-19 cases. The state Agency for Health Care Administration on Tuesday announced it was waiving prior-authorization requirements for non-emergency transportation services needed to transfer patients from hospitals to other facilities. “This change applies to the fee-for-service and managed care delivery system. These provisions apply to enrollees being transferred from a hospital regardless of diagnosis,” the announcement said. “The agency will continue this flexibility until further notice.” In a statewide phone call with hospital officials last week, state regulators were told that prior authorization requirements were leading to delays in transferring patients out of hospitals. But Audrey Brown, president and CEO of the Florida Association of Health Plans, said the delays were most likely attributable to other reasons and not to managed-care prior authorization requirements. Also, Brown said transportation delays that may be occurring are not due to managed-care plans’ prior authorization requirements. “The delay in ambulance is not about (prior authorization) it’s about a lack of ambulance availability,” she said in a statement to The News Service of Florida. The Department of Health also has waived requirements that ambulance providers first obtain certificates of need and public necessity before they can start offering services. “We hope that helps the situation,” Brown said.

Source: News Service Florida