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AmeriHealth NJ Waives Cost-sharing for COVID-19 Inpatient Treatment

AmeriHealth New Jersey also suspends prior authorizations for acute inpatient admissions and post-acute transfers

AmeriHealth New Jersey will waive member cost-sharing for in-network, inpatient, acute care treatment for COVID-19. This means members will pay no co-pay, co-insurance or deductible in this scenario.

AmeriHealth New Jersey will also waive cost-sharing for emergency department visits when members are admitted to the hospital under these same conditions. These changes are effective March 30, 2020 and will extend through May 31, 2020. The changes are for fully-insured business; self-insured customers can opt-out of coverage.

Also this week, in an effort to assist physicians and health care facilities during this crisis, AmeriHealth New Jersey announced that it would temporarily suspend prior authorizations for acute inpatient admissions from an emergency department at all in-network facilities for members with a COVID-19 diagnosis through April 30. In addition, prior authorization requirements are temporarily suspended for transfers from acute in-network inpatient facilities to post-acute in-network facilities (long-term acute care hospitals, rehabilitation or skilled nursing facilities) for any diagnoses. Notification from facilities is still required.

This includes suspending prior authorization requirements for in-network transportation from an acute inpatient facility to a post-acute facility. These steps are intended to facilitate and reduce administrative processes for the placement of COVID-19 patients to the most appropriate care settings.

AmeriHealth New Jersey will continue to evaluate these decisions and others as the COVID-19 situation evolves.

AmeriHealth New Jersey has taken early steps to promote public awareness to reduce the spread of COVID-19 and protect the physical and mental health of the people in the communities it serves. AmeriHealth New Jersey continues to serve customers at the highest level through several initiatives designed to assist our members, including numerous coverage policy changes, outreach by Registered Nurse Health Coaches, digital resources, and more.

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