Pre-authorization waived for fully insured consumers due to COVID-19, influenza and RSV starting Monday, Dec. 12 on a temporary basis
FOR IMMEDIATE RELEASE CONTACT: Jim Carson, 860-214-1539 Jim.Carson@ct.gov
Connecticut Insurance Department Commissioner Andrew N. Mais joins Public Health Commissioner Manisha Juthani and Department of Social Services Commissioner Deidre Gifford to announce that Connecticut consumers in a fully insured health plan will have pre-authorization requirements waived for short term post-acute care effective Monday, December 12 on a temporary basis.
Connecticut is facing a potentially serious challenge in hospital bed capacity in the coming weeks. Connecticut hospitals are seeing sharp increases in demand for services due to the simultaneous occurrence of influenza, RSV (Respiratory Syncytial Virus), COVID -19, and Behavioral Health surges. As a result, ensuring that hospital beds are available is a high priority. This issue will only be exacerbated as we prepare for the peak flu season this Winter and with RSV and COVID-19 cases on the rise.
“During this critical period, we must have the ability to discharge patients who no longer require an inpatient hospital bed in a timely manner. This will open beds for patients who require more intensive inpatient care,” said Commissioner Andrew Mais. “We understand how important appropriate prior authorization is as a tool to manage rising healthcare costs in our state, that’s why this is a temporary request to better manage the projected surge.”
“Starting with RSV and now with rising cases of flu and COVID, our hospitals are experiencing the anticipated surge of patients with respiratory viral diseases this season. The strain on the healthcare system is on the backdrop of staffing shortages that our hospitals have already been experiencing,” said Department of Public Health Commissioner Manisha Juthani. “This waiver of pre-authorization requirements will expedite the discharge of patients that are ready for an alternate level of care. It also will allow hospitals to provide the safest and highest quality of care to patients that need inpatient care the most.”
“We appreciate the collaborative approach that hospitals and insurers are taking to make sure patients can be appropriately cared for at the right level of care,” said Department of Social Services Commissioner Deidre Gifford. “It’s important that we minimize administrative delays during this important period, I want to thank Commissioners Mais and Juthani for their partnership in addressing this issue.”
The Connecticut Association of Health plans and their membership, Aetna/CVS Health, Anthem, CIGNA, ConnectiCare, and United Healthcare were all instrumental in expediting this change to address the potential health care crisis. Their effort during this extraordinary time is truly appreciated,” said Commissioner Mais.
The health insurance carriers have all committed to waive pre-authorization requirements for short term post-acute care for fully insured health plans and for Medicare, Medicare Advantage and Medicaid plans on a temporary basis.
Please note that the Connecticut Insurance Department does not regulate self-funded plans. All self-funded have an employer plan sponsor who would need to authorize any changes to waive the current pre-authorization requirements.