- (1) A member must receive prior authorization for preadmission, continued stay, and retroactive reviews.
- (2) An LTAC provider must submit to the Department a request for coverage that includes current and comprehensive documentation, or the Department will return the request as incomplete.
- (3) The Department shall consider LTAC coverage upon the date it receives the request with current, comprehensive documentation.
- (4) The Department shall review the documentation to determine preadmission, continued stay, or retroactive stay within three business days of the request.
- (5) An LTAC provider may not transfer prior authorization to another LTAC provider.
- (6) If a member transfers from an LTAC hospital to an acute care hospital for any reason, and is away from the LTAC hospital for more than 24 hours, the LTAC provider shall submit a new preadmission review before transferring the member back to the LTAC hospital.
- (7) The Department authorizes each approved prior authorization for up to 28 days.
KEY: Medicaid, long-term acute care, LTAC
Date of Last Change: November 1, 2023
Notice of Continuation: November 30, 2022
Authorizing, and Implemented or Interpreted Law: 26B-1-213; 26B-3-108