Service Authorizations for Health-Related Social Needs Services

REQUIREMENTS: By April 1, 2026: Billing and authorization teams must implement system edits to enforce authorization cutoff dates for HRSN Tenancy Services. Any new tenancy service authorizations completed on or after April 1, 2026 must be capped at September 30, 2027 end date (not the standard 18-month authorization period). Update authorization request forms and EMR templates to flag the 2027 sunset date. By April 1, 2027: Billing and authorization teams must update system rules for all other HRSN services (Rent and Utilities Financial Assistance, Storage Fees, Medically Tailored Meals, Nutrition Education, Pantry Stocking, and Fruit and Vegetable Benefits). Any new authorizations completed on or after April 1, 2027 must be capped at September 30, 2027 end date (not the standard 6-month authorization period). Immediate through September 30, 2027: Do NOT authorize or provide any HRSN services with dates of service after September 30, 2027. Deny any authorization requests attempting to extend past this date. Train all staff involved in HRSN authorization and billing on these cutoff dates. Consequences: Claims for HRSN services dated after September 30, 2027 will not be covered under the Medicaid waiver and will be denied. Authorizing services beyond this date creates claim liability for the practice.