Authorizations news

Submit transplant & NICU authorizations via our provider portal, effective Sept. 1

Starting Sept. 1, 2026, submit authorization requests for the following through our Provider Portal: NICU & sick newborn, solid organ transplant and bone marrow / stem cell transplant.

June 23, 2026

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Authorizations update for Medicare inpatient acute

Effective Sept. 1, 2026, you’ll no longer submit authorization requests for Medicare inpatient acute medical admissions.

June 17, 2026

Update to inpatient readmission review and appeal processes

In alignment with industry standards, inpatient readmissions for Medicare plans are now determined after the claim is submitted, rather than at the time of authorization review.

May 20, 2026

We'll use 2026 InterQual criteria starting July 13

Beginning July 13, 2026, we'll use 2026 InterQual criteria to make medical necessity determinations on prior authorization requests.

May 4, 2026

Reminder: 7 days is the new standard authorization turnaround time

As a reminder, the Centers for Medicare and Medicaid Services (CMS) now require health plans to decision standard authorization requests within seven (7) days of receipt. This change went into effect Jan. 1, 2026.

April 22, 2026

P2P update for Medicare inpatient acute authorizations

We’ve updated how we handle peer-to-peer conversations (P2P) for inpatient acute authorization denials for our Medicare, D-SNP and HIDE-SNP plans.

January 29, 2026

2026 scheduled maintenance dates for TurningPoint's authorizations portal

TurningPoint’s authorizations portal is intermittently offline for scheduled maintenance one evening per month, from 7 p.m. on a Saturday to 12 a.m. the following Sunday (Eastern Time).

December 30, 2025

We’re updating our processes for inpatient acute authorizations

We’re working to align our utilization management (UM) processes for inpatient acute authorizations for Medicare and Medicaid, and to ensure we’re in compliance with both CMS regulations and state recommendations for HIDE-SNP implementation.

December 10, 2025

TurningPoint annual provider survey

TurningPoint, which manages cardiac and MSK authorizations on our members’ behalf, is inviting our providers to participate in the Annual TurningPoint Provider Survey.

November 21, 2025

11/10/25: P2P update for Medicare inpatient acute authorizations

Effective Jan. 1, 2026, we’ll offer peer-to-peer reviews (P2Ps) for Medicare inpatient acute authorizations before issuing a denial, rather than after.

November 5, 2025

10/15/25: Varicose vein authorizations updates

We’re sharing two updates regarding varicose vein procedure authorizations.

October 15, 2025

09/25/2025: Home health care authorizations update

Many home health care services no longer require prior authorization for our in-network providers, effective Sept. 1, 2025.

September 29, 2025