Starting November 1, 2012, a new prior approval list will apply to all commercial and state-sponsored benefit plans underwritten by GHI HMO Select, Inc., HIP Health Plan of New York, HIP Insurance Plan of New York and Vytra Health Plans Managed Systems. Aside from a minor exception regarding the timing of submitting prior approval requests for PT/OT and chiropractic services, all prior approval rules for GHI HMO and HIP HMO will be the same. Further, our secure provider Web site is being modified to enable GHI HMO providers to submit their prior approval requests using the same online screens currently in use for HIP. This will allow GHI HMO providers to use the secure site to review the status of prior approval requests for all services, not just those related to inpatient care.
Please note: Due to a recent New York State mandate, prior approvals are no longer required for speech therapy related to autism spectrum disorder (ASD).
Effective January 1, 2013, a new prior approval list will apply to EmblemHealth Medicare HMO/PPO/ASO members. More information will be provided closer to the implementation date.