CommercialPrior AuthMedium impact
Prior Authorization Updates for Inpatient Hospice Requests
CareFirst BlueCross BlueShield·Palliative Care, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Sep 13, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield has updated their inpatient hospice prior authorization process. Instead of 14-day approvals requiring medical necessity review upfront, requests now auto-approve for 30 days, with medical necessity review only occurring on day 31 of the stay.
Action Required
Immediately: Update prior authorization workflows for CareFirst inpatient hospice requests. Billing team should note that approvals are now valid for 30 days instead of 14 days. Update tracking systems to reflect new approval periods and prepare for potential utilization management review after day 30 of stay.