This article is for providers caring for our members
Effectively immediately, transplant procedure authorizations for our commercial and Medicare Advantage members will be approved for two years, versus one year. Previously, authorization was approved for one-year and you were required to submit a clinical update to extend the authorization.
This change aligns the transplant authorization process for our commercial and Medicare Advantage members more closely with the authorization process for our Federal Employee Program (FEP) members. In February 2021, we began authorizing transplants for FEP members for a two-year time period, versus one-year.
Please note that you will need to monitor your patients’ eligibility starting one year after their initial authorizations to ensure their coverage hasn’t changed.