Blue Cross Blue Shield of Massachusetts is removing 14,000 prior authorization requirements for home care services for its 2.6 million commercial members beginning Jan. 1.
The new policy will be effective for Medicare Advantage members in 2025. Hospitalized members will not be required to receive advance approval before being discharged to receive in-home services, including physical and occupational therapies, along with visits from home health aides, nurses or social workers, according to a Nov. 6 news release.
Other payers have announced cuts to prior authorizations this year, including Cigna, BCBS Michigan and UnitedHealthcare. The efforts come ahead of proposed regulations from CMS that would require payers to approve urgent prior authorizations within 72 hours, and within seven days for standard requests. The rule would also require payers to publicly report prior authorization denial rates and provide specific reasoning for denied requests.