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May 5, 2020
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Broker Alert
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News for All Segments
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Helping members access care during the pandemic: Expanded prior authorization and extended benefit change
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As the COVID‑19 pandemic evolves, AmeriHealth New Jersey continues to work with local and national health officials to assess current conditions, health care for our members, and ways to help our clients and partners. We’d like to provide you with a few updates to previously communicated information.
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Expanded prior authorization for all acute, inpatient admissions from the emergency room
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In early April, we communicated that we are waiving prior authorizations for all in‑network, inpatient acute care treatment for COVID‑19. To further support members in getting access to the care they need, we have expanded this change to waive all prior authorizations for in‑network, acute inpatient admissions for any diagnosis from the emergency room. This change and the previously announced prior authorization waivers are being extended through June 4, 2020, including:
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- Transfers from acute, in‑network inpatient facilities to post‑acute, in‑network facilities, including long term acute care hospitals, inpatient rehabilitation, and skilled nursing facilities, for any diagnoses.
- Transportation between facilities.
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Benefit change extended to June 4
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We also communicated that we are waiving member cost share for in‑network, inpatient acute care treatment associated with COVID‑19 diagnoses. Given the current state of the COVID‑19 pandemic, this change is also being extended through June 4, 2020.
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We will continue to offer telemedicine for expanded services, including specialist visits until the end of the state of emergency. Telemedicine will be offered to fully insured group customers through MDLIVE.
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Prior authorization will also be waived for telemedicine for all diagnoses.
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If you have any questions, please contact your AmeriHealth New Jersey broker representative.
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