BCBS of Massachusetts Removes Prior Auth. Requirements for Homecare

BOSTON—Blue Cross Blue Shield of Massachusetts (“Blue Cross”) announced that it will remove prior authorization requirements for homecare services for commercial members beginning Jan. 1, 2024. This means hospitalized members will not be required to get advance approval before being discharged to continue treatment at home.

Homecare services include:

• Physical therapy
• Occupational therapy
• Home health aide and nurse visits
• Social worker visits

This change will eliminate 14,000 authorizations from the health care system, reduce administrative burden on clinicians and help hospitals expedite discharges at a time when many are struggling with overcrowding. It will also reduce delays for members ready to transition their care from hospital to home. 

“We know that prior authorization requirements can be an obstacle to access homecare services—resulting in delayed discharges and hospital capacity issues,” said Dr. Sandhya Rao, Blue Cross’ chief medical officer. “Our goal is to simplify our members’ discharge path to home with services that meet their needs.”