Prior authorization requirements are suspended for patient transfers from acute in patient hospitals to skilled nursing facilities effective December 20, 2022 to January 15, 2023. These adjustments apply to Medicare plan members receiving care from in-network providers. While prior authorization is not required, we require notification of the admission via the usual channels and clinical records on day two of admission to aid in our members’ care coordination and management. Anthem reserves the right to audit patient transfers, conduct retrospective reviews and to conduct concurrent reviews of skilled nursing starting the day after admission to those facilities.


OHBCBS-CR-015904-22



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Prior authorization suspension - In-network hospital transfers to In-network SNFs