A special message from Howard A. Cutler, Vice President, Healthcare Delivery

On behalf of Horizon BCBSNJ, thank you to all of our network health systems, physicians, hospital employees and other health care professionals working the front line of the COVID-19 outbreak. We appreciate your hard work, sacrifice, professionalism and commitment to providing excellent patient care.

To support your efforts, we’re working daily with the health care community and suppliers to ensure we understand the challenges you’re facing and to provide support during this critical time.

As the situation changes day by day — even hour by hour — we want you to know that we’ve made the following changes to help you provide care to your patients during this crisis. As of today, we have:

  • Waived prior authorization requirements for:
    • — Diagnostic tests and covered services that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19
    • — Lab studies or diagnostic testing for COVID-19 required during an ER evaluation or inpatient hospital stay
    • — All inpatient admissions with date of admission on or prior to May 31, 2020, unless extended
    • — Post-acute facility inpatient admissions to Skilled Nursing, Subacute Physical Rehabilitation and Inpatient Acute Physical Rehabilitation facilities for dates of admission prior to or on May 31, 2020, unless extended.
    • — Supplemental oxygen for all patients who are discharged from the ER prior to or on May 31, 2020, unless extended

    These changes take effect immediately for Horizon BCBSNJ members, including those covered through Medicaid, Medicare, fully insured and self-insured policies. Prior authorization for post-acute facility inpatient admissions to Skilled Nursing, Subacute Physical Rehabilitation and Inpatient Acute Physical Rehabilitation facilities is still required for Federal Employee Program® (FEP®) members.
  • Extended telemedicine rules to allow providers to deliver care via telephone.
  • Eliminated member out-of-pocket costs for telemedicine visits when delivered by an in-network health professional for all covered services, including COVID-19 testing and evaluation, routine care, therapy and mental health care.

Horizon BCBSNJ is committed to supporting your needs and the health care community. Last week, we announced our largest single donation made in our 88-year history. We are spending $2.35 million to donate 500,000 N95 respirator masks and 81,000 face shields to Governor Murphy’s coordinated response effort. We are also donating $100,000 to the Community Food Bank of New Jersey and $60,000 to the Jewish Family Service of Atlantic and Cape May, two organizations who are responding to the needs of New Jerseyans feeling the economic impact of the pandemic.

Please visit our dedicated COVID-19 page to read more about the changes we’ve made and to stay up to date on the latest information from Horizon BCBSNJ.

Again, thank you for your commitment and dedication in responding to the needs of our 3.5 million members and the entire state of New Jersey during this unprecedented health crisis.

Sincerely,

Howard A. Cutler
Vice President
Healthcare Delivery