[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-287365-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-287365-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","wellmed-disaster-page-10-102024","WellMed disaster page 10 10.2024","","WellMed outlines changes to Prior Authorization requirements to support members’ access to care while reducing administrative burden on providers. The document states that listed provisions and waivers are effective immediately, remaining in force until each item’s specified date. It references COVID-19 information hosting in ePRG and includes guidance across additional information areas, including discharge planning and continuity of care. It also provides nationwide and Texas disaster-related notices, with service categories, start, renewal, and expiration dates, plus specific waiver actions for impacted members.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/general/","General",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/wellmed-disaster-page-10-102024/287365/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/wellmed-disaster-page-10-102024/287365.png","ImageObject",442,249,{"name":42,"@type":43},"Gloria","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-22","2026-09-17",true,{"@type":52,"interactionType":53,"userInteractionCount":26},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"When do the Prior Authorization provisions and waivers take effect?","Question",{"text":62,"@type":63},"The listed provisions and waivers are effective immediately and remain in effect until the date specified for each item.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Where is the current version of the document posted?",{"text":67,"@type":63},"The current version is posted in the Provider Resources COVID-19 Information section on ePRG.",{"name":69,"@type":60,"acceptedAnswer":70},"What disaster-related waiver actions are included for Texas members impacted by severe storms?",{"text":71,"@type":63},"For Texas, pre-authorization requirements may be waived for impacted members, and non-par claims may be reprocessed as par subject to eligibility based on zip and county listings.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},287365,1790094705,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,113,118,123],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},17,"Forms",40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":4,"slug":125},158,"general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":124,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":26,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":94,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":139,"read_time":121},2336474459895,"https://ap-avatar.wpscdn.com/avatar/22000baeef7a5ed0655?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786071322749376916","WellMed is making the following changes to our Prior Authorization requirements to assist our members to access care and reduce administrative burden on our providers. The provisions and waivers listed below are effective immediately and will remain in effect until the date specified for each item. The most recent changes are in red font. The current version of this document is posted in the Provider Resources COVID-19 Information section on ePRG.  \nAdditional Information  \n1  \n\n| Additional Information | Discharge Planning | Continuity of Care |\n| --- | --- | --- |\n| Unless specifically included in the waivers / changes in this | We are ready to assist you with discharge planning for our members. | Consistent with existing policy new prior authorizations are not |\n| memorandum, all other prior authorization requirements for non- | Please contact your market WellMed Inpatient Case Manager for | required when a member transfers to a new provider. New provider |\n| COVID-related services are still in effect per the applicable prior | assistance. | must notify us of change to trigger transfer of existing authorizations |\n| Authorization list. Send questions to |  |  |\n| [MMEmergencyDeclarationUMCM@wellmed.net](MMEmergencyDeclarationUMCM@wellmed.net). |  |  |\n\n\n| Nationwide | Service | Start Date | Renewal\u003Cbr>Date | Expiration\u003Cbr>Date | Specifics |\n| --- | --- | --- | --- | --- | --- |\n|  | Notice | 10/26/2017 | 09/19/2024 | 12/18/2024 | The Secretary of Health and Human Services has declared a nationwide emergency in response to the ongoing opioid crisis |\n| HHS Secretary Extends Public Health Emergency for the National Opioid Crisis Renewal 7.3.24\u003Cbr>update \\#2 | Gatekeeper\u003Cbr>Referrals | 10/26/2017 | 09/19/2024 | 12/18/2024 | Waive, in full, requirements for gatekeeper referrals where applicable. |\n|  | OON Facilities | 10/26/2017 | 09/19/2024 | 12/18/2024 | Cover Medicare Parts A and B services and supplemental Part C plan benefits furnished at non-contracted facilities subject to § 422 . 204(b) (3) . |\n|  | Cost Sharing | 10/26/2017 | 09/19/2024 | 12/18/2024 | Temporarily reduce plan-approved out-of-network cost-sharing to in-network cost-sharing amounts |\n| Applicable delegated Health Plan: Cigna | Impacted\u003Cbr>Counties | 10/26/2017 | 09/19/2024 | 12/18/2024 | Nationwide |\n\n2  \n\n| State of Texas | Service | Start Date | Renewal\u003Cbr>Date | Expiration\u003Cbr>Date | Specifics |\n| --- | --- | --- | --- | --- | --- |\n|  | Notice | 04/26/2024 | 09/26/2024 | 10/26/2024 | The Governor of Texas has declared a state of emergency due to Severe Storms. This declaration applies to 125 counties. Humana has provided the counties and zip codes impacted by this event. As a Delegated provider, there are specific CMS actions (CMS memo dated 2017) to implement for this event.\u003Cbr>Based on this, the following actions need to occur to comply with CMS Disaster Guidance: |\n| Action-AmendedTexas-Governor DeclarationSevere Storms- 125 counties\u003Cbr>Update \\# 14 | Preauthorization\u003Cbr>Requirements | 04/26/2024 | 09/26/2024 | 10/26/2024 | Waive pre-authorization requirements for members that identify themselves as being impacted by the disaster. |\n|  | OON Facilities | 04/26/2024 | 09/26/2024 | 10/26/2024 | Reprocess non-par claims as par, for members that identify themselves as being impacted by the disaster. Refer to zip and county listing for eligibility. |\n| Applicable delegated Health Plan:\u003Cbr>Humana | Impacted\u003Cbr>Counties | 04/26/2024 | 09/26/2024 | 10/26/2024 | Anderson, Angelina, Austin, Bailey, Bandera, Bastrop, Baylor, Bell, Bexar, Blanco, Bosque, Bowie, Brazos, Brown, Burleson, Burnet, Caldwell, Calhoun, Cass, Chambers, Cherokee, Clay, Coleman, Collin, Colorado, Comal, Concho, Cooke, Coryell, Dallas, Delta, Denton, DeWitt, Dickens, Eastland, Ellis, Falls, Fannin, Fayette, Freestone, Galveston, Gillespie, Gonzales, Gregg, Grimes, Guadalupe, Hamilton, Hardin, Harris, Haskell, Hays, Henderson, Hill, Hockley, Hood, Hopkins, Houston, Hunt, Jasper, Jefferson","cbCaiaMNIxbHd1HR","https://ap.wps.com/l/cbCaiaMNIxbHd1HR","pdf",461322,"English","# Additional Information\n## Discharge Planning\n## Continuity of Care\n# Nationwide Notice and Waivers\n## Gatekeeper Referrals\n## Out-of-Network Facilities and Cost Sharing\n# State of Texas (Severe Storms) Notice and Waivers\n## Preauthorization Requirements\n## Out-of-Network Claims Reprocessing","[{\"question\":\"When do the Prior Authorization provisions and waivers take effect?\",\"answer\":\"The listed provisions and waivers are effective immediately and remain in effect until the date specified for each item.\"},{\"question\":\"Where is the current version of the document posted?\",\"answer\":\"The current version is posted in the Provider Resources COVID-19 Information section on ePRG.\"},{\"question\":\"What disaster-related waiver actions are included for Texas members impacted by severe storms?\",\"answer\":\"For Texas, pre-authorization requirements may be waived for impacted members, and non-par claims may be reprocessed as par subject to eligibility based on zip and county listings.\"}]","WellMed disaster page 10 10.2024 | PDF",1789632215]