February 1, 2022
As recommended in New York State Department of Financial Services Insurance Circular Letter No. 1 dated January 6, 2022, Wellcare NY has suspended the following prior authorization requirements for Medicare products:
- Hospital to Hospital transfer between participating facilities
- The hospital is expected to use its best efforts to provide notice to Wellcare within 48 hours of the transfer.
- Please include information necessary for Wellcare to assist in coordinating care and discharge planning.
- Skilled Nursing Facilities (SNF)
- Providers will have up to 7 days to notify Wellcare of the admission.
- Wellcare will approve the first 7 days of the stay, and will conduct concurrent review for all days beyond day 7.
Wellcare will continue to monitor guidance from New York State.