Medicare AdvantagePrior AuthHigh impact
Reminder: Change in prior authorization administration for post-acute care services, effective January 1, 2026
Cigna·PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
Effective January 1, 2026, HealthSpring will take over prior authorization management for Post Acute Care services (Skilled Nursing, Inpatient Rehab, Long Term Acute Care, and Home Health) from EviCore for Cigna Healthcare Medicare Advantage patients. Providers must submit authorization requests through the Availity Provider Portal to HealthSpring instead of EviCore starting December 29, 2025.
Action Required
By December 29, 2025: Billing and clinical teams must redirect all Post Acute Care prior authorization requests with dates of service beginning January 1, 2026 or later to HealthSpring through the Availity Provider Portal instead of EviCore. Update workflows to ensure PAC facilities submit concurrent reviews at least two days before current authorization end dates. Contact HealthSpring_Home_Health_Clin_Ops@hcsc.com for Home Health questions and HealthSpring_Post_Acute_Clin_Ops@hcsc.com for Post Acute questions. Review new procedural code lists at HealthSpring.com/Providers starting January 1, 2026.