Hurricane Helene: Important Information for Providers

Date: 09/25/24

To support providers and help keep our members safe through Hurricane Helene, Sunshine Health is waiving all prior authorization requirements for critical Medicaid services in impacted counties for all Medicaid products: MMA, Child Welfare Specialty Plan (CWSP), Serious Mental Illness (SMI), Children’s Medical Services Health Plan (CMS) and Long Term Care (LTC).

The extended temporary flexibilities to our prior authorization requirements began on September 25, 2024, and extend until further notice.

Early prescription refill edits have also been lifted for all maintenance medications (Note: This does not apply to controlled substances).

Additionally, if a recipient requires critical Medicaid services beyond limits stated in policy to maintain safety and health, providers can furnish the service.

All Preadmission Screening and Resident Review (PASRR) processes are postponed until further notice by the Agency for Health Care Administration (Agency).

• Retroactively performed screenings or resident reviews must document the reason for delay in the completion of PASRR requirements.
• The Agency is waiving the PASRR process for recipients who evacuated due to an evacuation order or power outage and are admitted and discharged during the storm.

Additional information for providers is located on the Agency’s website.

Thank you for serving our members every day, and especially during this time.

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