DHS COVID-19 PROVIDER RESOURCES // OMAP
Managed Care Ops Memo 05/2020-012:
Elective Services
Issued: May 7, 2020
Audience
: All HealthChoices Physical Health Managed Care Organizations — Statewide
Purpose
The Office of Medical Assistance Programs (OMAP) is issuing this Operations
Memorandum to provide revised direction regarding the authorization of elective
services during the COVID-19 emergency.
Background
On March 6, 2020, Governor Tom Wolf issued a public health emergency
declaration in response to the presence of the COVID-19 virus in Pennsylvania. The
COVID-19 outbreak was declared a national emergency under the Stafford Act on
March 13, 2020, and a nationwide public health emergency on January 31, 2020
(retroactive to January 27, 2020).
Discussion
On April 27, 2020 the Department of Health issued updated guidance on Hospitals’
Response to COVID-19. Hospitals may begin to allow elective admissions and
may begin performing elective surgeries and procedures if the hospital makes
an affirmative decision that it is able to do so without jeopardizing the safety of
patients and staff or the hospital’s ability to respond to the COVID-19
emergency.
On April 27, 2020 the Department of Health also issued updated guidance on
Ambulatory Surgical Facilities’ (ASFs) Responses to COVID-19. ASFs may begin
performing elective surgeries and procedures if the ASF makes an affirmative
decision that it is able to do so without jeopardizing the safety of patients and
staff or the ASF’s ability to respond to the COVID-19 emergency.
Next Steps
PH-MCOs should review the guidance issued by the Department of Health included
in the Operations Memorandum and resume normal practices for review and
approval of elective procedures. If a PH-MCO issued any authorizations with the
future effective date of July 1, 2020 those authorization must be reissued with a
current effective date.