COVID-19 - Health benefit plans urged to waive prior authorization

BULLETIN Number 21-B-09 ADVISORY To: All Insurance Companies and other Entities Licensed under Chapter 58 of the North Carolina General Statutes From: Life & Health Division Date: August 26, 2021 Subject: COVID-19 Delta Variant Surge Due to the COVID-19 delta variant surge, in-patient admissions due to the virus are increasing. The North Carolina Department of Health and Human Services (NC DHHS) reports that as of August 25, 2021, 3,552 people are currently hospitalized due to COVID-19. NC DHHS has stated that this increase in hospitalizations is placing extreme pressure on hospital capacity in North Carolina. The North Carolina Department of Insurance (the Department) is issuing this advisory to encourage insurers that offer health benefit plans to North Carolina residents to take the following immediate measures related to the COVID-19 delta variant surge: • Waive prior authorization requirements for post-acute care: The Department requests that insurers temporarily waive prior authorization requirements for postacute care. This would include post-acute placements in skilled nursing facilities, home health, and residential treatment centers. Waiving prior authorization requirements for post-acute care should allow hospitals to move admitted patients more quickly to a lower level of care, freeing up hospital beds for new patients. The Department is requesting this temporary waiver to be for at least 30 days from the date of this advisory and until hospitalization rates have lowered. To allow the Department to respond to consumer inquiries, the Department further request that all insurers offering health benefit plans in North Carolina communicate to the Department whether they are temporarily waiving prior authorization requirements for post-acute care and for how long. Please refer any questions to this advisory to the attention of Ted Hamby at LHInbox@ncdoi.gov.