We're ending the temporary suspension of clinical review requirements for admission to skilled nursing facilities
On Feb. 28, 2022, the temporary suspension of clinical review requirements for admission to skilled nursing facilities for all Michigan hospitals and for hospitals in certain other states will end.
For SNF stays starting on or after March 1, 2022, clinical review will be required on day 1 of the stay.
The temporary suspension went into effect for Blue Cross Blue Shield of Michigan commercial, Medicare Plus BlueSM, Blue Care Network commercial and BCN AdvantageSM members as follows:
- On Sept. 1, 2021, for admissions to SNFs for hospitals in certain states. See this Provider Alert (PDF) for details.
- On Sept. 20, 2021, for admissions to SNFs for hospitals in Michigan. See this Provider Alert (PDF) for details.
These changes will be reflected in the following documents, which are available on our coronavirus webpage available through Provider Secured Services:
- Temporary changes due to the COVID-19 pandemic — This document is also available on our public website at bcbsm.com/coronavirus (click the Health Care Providers tab).
- Ends Feb. 28, 2022: Clinical review requirements temporarily suspended for admissions to skilled nursing facilities from hospitals in certain states
In addition, the change for hospitals in certain states is reflected in the following documents for out-of-Michigan providers, which are available from the Medical Policy & Pre-Cert/Pre-Auth Router page of our bcbsm.com website:
- Provider Preauthorization and Precertification Requirements (PDF) for Blue Cross commercial and Medicare Plus Blue members
- Non-Michigan providers: Referral and authorization requirements (PDF) for BCN commercial and BCN Advantage members
Posted: March 2022
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network