Blue Cross Blue Shield of North Dakota (BCBSND) Medicaid Expansion wants to share some important changes coming Jan. 1, 2025 for prior authorization requirements.
For dates of service Jan. 1, 2025 and after, prior authorization requirements for 1915(i) home and community services will no longer be required. 1915(i) providers will follow the1915(i) DHHS plan “Home and Community-based Services administration of operation guide located at hhs.nd.gov/sites1915i ND.pdf. Services that are delivered outside of the administrative guidelines need review for medical necessity prior to administration of services.
For 1915(i) services provided prior to Dec. 31, 2024, providers are required to follow the 2024 prior authorization requirements for service approval. All 1915(i) services prior to Jan. 1, 2025, require prior authorization. Follow the step-by-step process guidance to assist you with how to check if authorization is required, as well as how to submit an authorization for review.
Looking for more 1915(i) information?
Review the Medicaid Expansion 1915(i) Providers | BCBSND webpage and watch for updates to our webpage prior to January 2025.
Questions?
Contact our Provider Service Center at 1-833-777-5779.
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