COVID-19 Provider Bulletin - Community Health Plan of Washington - Medicare Advantage

COVID-19 Provider Bulletin

Community Health Plan of Washington Information on COVID-19

Provider Bulletin: September 8, 2021

Dear Provider:
We are providing an update to information for you regarding your work with CHPW around COVID-19. Please share this information with your clinical and administrative staff, as needed.

CHPW is ready to partner with you in any ways we can be of assistance. You are not alone… Please reach out to us if you think of anything.

UPDATED INFORMATION as of 9/8/2021 (Information is subject to change)

The information in this section reflects new or revised information since the last dated bulletin.

Medicaid Utilization Management

CHPW has changed some authorization processes effective 8/11/2021 to support facilities during the current COVID capacity issues resulting from the Delta variant:

SNF admissions

The first 10 days of any SNF stay will be approved without review to facilitate faster discharges from acute facilities. CHPW will accept late notifications for SNF admissions, which will allow acute facilities and SNFs to coordinate transfers without waiting for approval from CHPW. CHPW still will need notification from the SNF once the member admits so we can support discharge planning and concurrent review starting on day 10 of the SNF stay.

Hospital Transfers

CHPW will allow lateral transfers from one acute facility to another (as long as medical necessity was still met at the first acute facility) to address capacity issues. Initial facility admission must still be approved by CHPW at time of transfer. CHPW needs notification from the accepting facility once the member transfers but prior authorization is not needed to coordinate the transfer.

NOTE: These changes are in effect until November 15th, 2021. CHPW will review for possible extension depending on the COVID situation at that time.

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Previous COVID-19 Provider Bulletins

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