MedicaidPrior AuthHigh impact
Reinstatement of Prior Authorization Requirements pdf
Connecticut Medicaid (HUSKY Health)·CT·Prior Authorization
Effective date
Apr 20, 2021
We identified it
Jun 20, 2026
Summary
COVID-19 emergency prior authorization waivers are ending April 20, 2021, requiring CMAP providers to obtain prior authorization for inpatient admissions, outpatient behavioral health, advanced imaging, home health services, dental endodontics, and medical equipment. Providers must immediately begin securing prior authorizations for all services in these categories for dates of service April 20, 2021 and forward.
Action Required
By April 20, 2021: Billing team and providers must reinstate prior authorization processes for in-state and border inpatient hospital admissions, inpatient hospice stays over 5 days, outpatient behavioral health services, advanced radiology and imaging services, home health services, dental endodontic services, and medical equipment/devices/supplies. Update billing system to flag these service categories for prior auth requirements. Train staff to verify authorizations before scheduling. Claims will be denied without proper prior authorization.