Medicare AdvantagePrior AuthMedium impact
Announcing change to authorizations for Medicare Advantage members’ interrupted stays at skilled nursing facilities
BCBS Michigan·MI·Medicare
Effective date
Feb 6, 2026
We identified it
Jun 16, 2026
Summary
WellSky changed the authorization rules for Medicare Advantage members who have interrupted skilled nursing facility stays. Starting Feb 6, 2026, if a member returns to the same SNF after two or more midnights have passed (previously one day), a new authorization number will be created instead of using the original one.
Action Required
Immediately: Billing team must update procedures for Medicare Advantage SNF claims with interrupted stays. When members return to the same SNF after two or more midnights have passed, use the new authorization number from WellSky instead of the original one. Continue submitting only one claim for both stays and include the initial stay's prior authorization number if choosing to include authorization on claims.