DOI Issued Official Bulletin On Friday
State officers have instructed well being insurers to be versatile with dealing with prior authorizations for sufferers and credentialing well being care employees who’re impacted by the upcoming closures of Carney Hospital and Nashoba Valley Medical Heart.
In a Friday bulletin, the Division of Insurance coverage mentioned it expects business well being insurers, well being upkeep organizations, and Blue Cross Blue Defend of Massachusetts to waive prior authorization critiques for 60 days for “any beforehand permitted surgical procedures, procedures and behavioral well being or non-behavioral well being admissions at Carney Hospital and Nashoba Valley Medical Heart that should be transferred to a different facility upon discover of the up to date location and date of service.”
The pliability applies to inpatient and outpatient surgical remedies that had been scheduled at Carney and Nashoba, in response to the bulletin, which was circulated Monday by the Massachusetts Health and Hospital Association.
Over the subsequent 60 days, insurers ought to be “actively concerned” with serving to to coordinate different look after sufferers who’re being handled at Carney or Nashoba, together with these in inpatient beds or going by way of outpatient remedy, in response to the bulletin.
Steward Well being Care plans to shut the Carney and Nashoba services on or round Aug. 31.
As well being care employees at Carney and Nashoba discover employment at different well being care programs, DOI has requested insurers to make changes to their credentialing insurance policies to expedite the method for people who “are searching for to be newly credentialed by a Provider, or who’re searching for to change the supplies which might be a part of an present credentialing file,” in response to the bulletin.
A MassHealth memo despatched Friday outlined comparable prior authorization flexibilities related to Carney and Nashoba, along with accelerating the credentialing course of for employees becoming a member of different hospitals or supplier programs.
“For 60 days after the issuance of this bulletin, MassHealth will switch prior authorizations and pre-admission screenings for any beforehand permitted surgical procedures, procedures, and behavioral well being or non-behavioral well being admissions at Carney Hospital and Nashoba Valley Medical Heart that should be transferred to a different facility,” the memo mentioned.
