Medicare AdvantagePrior AuthHigh impact
BCBSRI suspending certain prior authorizations
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Dec 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI has suspended prior authorization requirements for urgent/emergent inpatient care, long-term acute care, acute inpatient rehabilitation, and skilled nursing services during COVID-19. While prior auth is waived, providers must still submit admission and discharge notifications within 48 hours to ensure proper reimbursement.
Action Required
Immediately: Stop obtaining prior authorization for urgent/emergent inpatient admissions, long-term acute care, acute inpatient rehab, and skilled nursing services for BCBSRI members (except FEP non-COVID cases). Continue submitting admission notifications via portal within 48 hours and discharge notifications within 48 hours. For SNF admissions, notify by day 3. Elective hospital procedures still require prior auth. Contact utilization management at (401) 272-5670 for questions.