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DHS COVID-19 PROVIDER RESOURCES // OMAP

CHIP Policy Clarification 2020-03: 
Directions to Bypass the Prior Authorization Requirements for CT Scans of the Chest for COVID-19 Patients

Issued: March 24, 2020; Updated: June 17, 2020

Purpose

To provide directions to bypass the prior authorization requirements for CT Scans of the Chest for COVID-19 patients.

Background

On March 11, 2020, Governor Wolf issued a press release announcing that CHIP will cover COVID-19 testing and treatment for recipients and is lifting some prior authorization requirements to ease access to necessary testing and treatment.  

Discussion

The Office of CHIP recognizes that patients with or being tested for COVID-19 may need a Computed Tomography scan, known as a CT Scan of the chest. To that end, CHIP MCOs should not require a prior authorization for a CT scan of the chest when the patient has or is being tested for COVID-19. 

MCOs should contact their in-network providers advising them of the waiver of prior authorization requirements for CT Scans.

Next Steps

  1. Review the information in this policy clarification with appropriate staff. 
  2. Implement this policy clarification immediately.
  3. This policy clarification will remain in effect while a valid disaster declaration authorized by the Governor related to the COVID-19 virus remains in effect. The OOC may re-issue this policy clarification as appropriate. 
  4. Questions concerning this transmittal should be directed to Virginia Perry at (717) 772-1110 or via email at virperry@pa.gov