Back to Insights and Updates for ProvidersAugust 2023

Update on authorization requests for home care and hospice

Harvard Pilgrim Health Care Commercial

We want to make providers aware of a change related to requests to extend an existing authorization for home care and hospice services for Harvard Pilgrim Health Care commercial members. Currently, if an extension request is approved, the authorization is updated with additional units and the end date is extended.

Effective for dates of service beginning Oct. 1, 2023, providers must request a new authorization for services that extend beyond the end date of the existing authorization. Each approved authorization for the patient will have its own authorization number.

The existing criteria for hospice and home care services is not affected. For more information, please refer to the Home Health Care and the Hospice and Palliative Care Services medical necessity guidelines.

Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

Joseph O’Riordan, Susan Panos, Stephen Wong,

Kristin Edmonston,
Production Coordinator

Kristina Cicelova,
Graphic Designer