Prior Authorization Waivers Extended to Feb. 28, 2022

Date: 12/08/21

Fort Lauderdale, Florida

NOTE: Please see update to this news item.

Thank you for your partnership with Sunshine Health and Children’s Medical Services Health Plan. As part of our commitment to deliver the most up-to-date information, we want to share important information about prior authorizations:

• We are waiving prior authorizations for the following covered services:
  • Hospital-based, ambulatory-surgery center and office-based outpatient procedures (location codes 11, 22 and 24) for dates of service between October 1, 2021, and February 28, 2022. The services include but are not limited to: Labs, radiology and outpatient surgery.
  • Outpatient and home-based therapy for children ages 0-3 or provided by an EIS provider for dates of service between October 1, 2021, through March 31, 2022.
• This waiver applies to Medicaid, Serious Mental Illness Specialty Plan, Child Welfare Specialty Plan, Long Term Care and Children’s Medical Services Health Plan products.
• This waiver applies to services authorized by a Sunshine Health vendor.
• Action needed: Please do not submit requests for the above listed services.
• For any requests that were already submitted through Sunshine Health’s Secure Provider Portal or via fax, the provider will receive a notice with the authorization rejection due to no auth needed for dates of service.
• Sunshine Health will pay claims submitted during those dates of services. It could take up to three days after submission for providers to see a final claims disposition in the Secure Provider Portal.
• Please share this communication with intake, patient scheduling and billing departments.

For questions or concerns, please contact Sunshine Health Provider Services at 1-844-477-8313.