Temporary waiver of authorization for post-acute facilities

Mass General Brigham Health Plan is waiving prior authorization requests from January 9, 2024 until April 1, 2024 for patient transfers from acute care hospitals to sub-acute care facilities and rehabilitation facilities. This applies to initial admission to the sub-acute and/or rehabilitation. This is in support of the recent directive from the Massachusetts Executive Office of Health and Human Services (EOHHS).

Notice of Admission (NOA)

Notifications should be submitted by the respective Skilled Nursing and Acute Rehabilitation facilities within 24 hours of admission and updates provided a minimum of every 5 days to support discharge planning. 

Concurrent review and retrospective review will proceed (if notification occurred) to determine appropriateness of level of care.

Included in this waiver

  • Medicaid, Commercial and Medicare lines of business
  • INN providers
  • OON providers within Massachusetts

Excluded from this waiver

  • Long Term/custodial care
  • Out of network providers outside of Massachusetts

Streamlining your experience

Get prior authorization approvals instantly with the  easy-to-use tool in our provider portal. Not registered for our portal yet? No problem — that's easy too. Learn more about our digital tools

Save time on outpatient authorization requests

  • For outpatient services that meet criteria, you will receive approvals in seconds
  • Request authorization and enter medical necessity information in one screen
  • Get approvals 24-hours a day, 7 days a week

How to submit authorizations to our partners

Resources for your practice

From our blog

Speed up authorization determinations
Dr. Lisa M. Scarfo, MD shares common misconceptions about medical necessity and advice you can start using today. Read more

5 tips for a great experience
Get the most out of our online authorization tools with five simple tips. Read more