As the COVID-19 pandemic continues to spread throughout our communities, we support front-line providers as they provide care to our members.
In addition to the proactive steps Anthem has already taken to support care providers and protect our members, associates, and communities against COVID-19, Anthem in Georgia is taking additional measures outlined by the Georgia Department of Insurance in Directive 21-EX-1 and Directive 21-EX-2, asking all insurers to suspend certain utilization management review and notification requirements to free up staff for clinical support.
We are suspending:
- Preauthorization Requirements for Scheduled Surgeries or Admissions at Hospitals
- Concurrent Review for Inpatient Hospital Services
- Preauthorization Requirements for Post-Acute Placements
Anthem has agreed to comply with these measures for our commercial Individual, employer-based fully-insured, self-insured (ASO), and Medicare plans for one month, starting August 16. We will consider extending compliance if needed. Self-insured plans have the option to opt-out of the DOI request because they are not insured.
Georgia employers that offer self-funded plans must complete our opt-out acknowledgment form by Friday, September 3, 2021, if they do not wish to waive utilization management review and notification requirements for one month, starting August 16, and consider extensions as needed. If an opt-out acknowledgment form is not received within that time period, utilization management review and notification requirements will be waived, as described in the directive.
We will share additional information on this and other pandemic-related changes on Producer News.