Medicare AdvantagePrior AuthMedium impact
BCBSRI suspending prior authorizations for Skilled Nursing admission ONLY effective December 31, 2021
Blue Cross Blue Shield of Rhode Island·RI·Facility
Effective date
Dec 31, 2021
We identified it
Jun 19, 2026
Summary
BCBSRI is temporarily suspending prior authorization requirements for Skilled Nursing Facility admissions from December 31, 2021 through February 28, 2022, affecting Medicare Advantage and all other products except Federal Employee Program. Facilities must still notify the Utilization Management team by day three of admission and continue concurrent stay reviews.
Action Required
For BCBSRI Medicare Advantage and commercial members (except FEP): Stop obtaining prior authorization for SNF admissions through February 28, 2022. Must notify Utilization Management team by day three of admission by faxing clinical information to (401) 459-1623 (or (401) 429-6377 for Prospect members). Continue all concurrent stay review processes. Contact SNF UM team at (401) 459-1000 ext. 3364 with questions.