Kentucky: Prior authorization and site of service update
Update Aug. 1, 2021: We previously announced an Aug. 1, 2021, implementation date for prior authorization and site of service reviews for commercial plans in Kentucky. Please note, we’re delaying the implementation date to Oct. 1, 2021, as outlined below.
For dates of service on or after Oct. 1, 2021, for UnitedHealthcare commercial plans, we’re expanding our prior authorization requirements to include certain surgical, screening colonoscopy, office and MRI/CT imaging procedures in Kentucky.
We’ll conduct site of service medical necessity reviews for surgical, screening colonoscopy and MRI/CT imaging procedures if the procedure is requested to be performed in anoutpatient hospital setting
For office-based procedures, we’ll conduct site of service medical necessity reviews if the procedure is requested to be performed in an ambulatory surgical center
We’ll use the following utilization review guidelines to facilitate these site of service medical necessity reviews: