Medicare AdvantagePrior AuthHigh impact
BCBSRI suspending prior authorizations effective December 1, 2020
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Dec 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI is suspending prior authorization requirements for urgent/emergent inpatient care, long-term acute care, acute inpatient rehabilitation, and skilled nursing services due to COVID-19. While prior auth is waived, notification requirements within 48 hours of admission/discharge still apply to ensure proper reimbursement.
Action Required
Immediately: Stop obtaining prior authorizations for urgent/emergent inpatient stays, long-term acute care, acute inpatient rehab, and skilled nursing services for BCBSRI members (except FEP plans). Continue to notify BCBSRI within 48 hours of admission and discharge via provider portal or fax. Update staff workflows to maintain notification requirements while skipping prior auth steps. Elective hospital procedures still require prior authorization.