In previous issues of Insights and Updates for Providers, Point32Health announced that we would begin requiring prior authorization for elective inpatient medical admissions for Harvard Pilgrim Health Care Commercial members beginning April 1, 2026, and would apply level of care reviews. 

Please be aware that, based on further review of utilization management processes and feedback from our esteemed provider partners, we have elected not to proceed with this change and will no longer be implementing this new prior authorization requirement or InterQual medical necessity reviews. 

Providers should continue to follow existing authorization processes for any drugs or services requiring prior authorization, and there will be no change to the existing notification process for the elective inpatient medical admission itself. This includes elective oncology admissions for the administration of chemotherapy drugs. 

For more information on notification requirements for elective inpatient medical admissions, refer to the associated policies in the Referral, notification, and authorization section of our Harvard Pilgrim Commercial Provider Manual.