Point32Health prioritizes timely and appropriate patient care, and we want to support our provider network in delivering it with minimal disruption and administrative burden, regardless of the current health care landscape.
To that end, we’ve instituted temporary flexibilities in support of a recent directive from the Massachusetts Executive Office of Health and Human Services (EOHHS), which will remain in effect from Jan. 9 – April 1, 2024. These flexibilities are intended to facilitate care coordination and expedite patient transitions to the proper care setting amid the severe capacity challenges impacting the Massachusetts health care system.
In accordance with the EOHHS directive, we are waiving prior authorizations from Jan. 9, 2024 until April 1, 2024 for admissions from acute care hospitals to Massachusetts sub-acute care facilities and rehabilitation facilities for all applicable* Harvard Pilgrim Health Care and Tufts Health Plan products (commercial, Medicare Advantage/Senior Products, and Public Plans lines of business).
You can read about the steps Point32Health is taking, as well as some responsibilities on the part of facilities in our network, in greater detail on the MA prior authorization waiver page on our Point32Health provider website.
*Please note that the prior authorization waiver does not apply for US Family Health Plan, a TRICARE Prime health plan for eligible military families for which Tufts Health Plan provides administrative services.
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