The next 90 days are critical for the healthcare system due to the prevalence of three viruses, workforce shortages and hospital capacity issues. Governor Baker and the Secretary of Health and Human Services, Mary Lou Sudders have asked all providers in the Commonwealth’s health care system to assist in building capacity and ensuring timely throughput. After consulting with the Mass Senior Care leadership, we have committed for the next 90 days to extending our admissions hours to accept admissions Monday through Saturday from 9am-7pm at a minimum and will continue capacity-building efforts to accommodate admissions 24/7.
In addition, hospitals and health plans have committed to the following:
- Hospitals have agreed to commence their discharge planning as early in the day as possible. In addition, MHA has agreed to renegotiate their contract with a staffing agency to bring additional clinical inpatient psychiatric staff into the state and bring more inpatient psychiatric capacity online.
- Health Plans – have agreed to voluntarily waive prior authorization for 90 days beginning on December 6, 2022, and ending on March 6, 2023, for admissions from acute care hospitals to sub-acute care facilities and rehabilitation facilities across commercial, Medicaid, Medicare, and Medicare Advantage lines of business. Plans will encourage self-insured plan sponsors to adopt the waiver.
- The waiver does not apply to long-term or custodial admissions.
- Health plans will be permitted to conduct retrospective and concurrent review during this time to determine appropriateness of level of care.
- Acute care hospitals and post-acute care facilities will be expected to notify plans about any inpatient admission for which post-acute care is anticipated within 24 hours of admission and to provide updates, at a minimum of every 5 days, to support discharge planning.