Acute Care Setting to Skilled Nursing and Acute Rehab Facilities
Posted on January 12, 2024
Effective January 9 – April 1, 2024, for our Commercial (fully funded),* BeHealthy Partnership and Medicare Advantage members, Health New England will:
- Allow good faith admissions to skilled nursing facilities (SNF) and acute rehabilitation facilities from the acute care setting without prior authorization.
- Cover the initial 7 days of the SNF/acute rehab stay.
- Conduct retrospective and concurrent review during this time period to determine appropriateness of level of care.
In addition, the Post Acute Facility (Skilled Nursing Facility/Acute Rehab) will:
- Notify Health New England of a good faith admission to their facility with 24 hours of the member’s admission.
- Provide updates, at a minimum of every 5 days, to support discharge planning.
Click here to learn more.
*This may be applicable to some self-funded employer groups. Please call Member Services at (800) 842-4464, extension 5025, to understand benefits.
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