New states in-scope for naviHealth post-acute care

Effective Oct. 1, 2021, naviHealth will start managing post-acute care for UnitedHealthcare^® Medicare Advantage members in Arkansas, Delaware, Hawaii, Idaho, Louisiana, Mississippi, Montana, Nevada, Pennsylvania, Utah, West Virginia and Wyoming. This is in addition to the post-acute care management change that went into effect for certain states on June 1, 2021, and Aug. 1, 2021.

This includes prior authorization, concurrent (continued stay) review and discharge planning for members transitioning to and receiving skilled care in:

• Skilled nursing facilities (SNFs)
• Acute Inpatient Rehab (AIR)
• Long-Term Acute Care (LTAC) 

Plans included: 

• Medicare Advantage Plans previously managed by UnitedHealthcare
• Dual Eligible Special Needs Plans (DSNP)
• Chronic Special Needs Plans (CSNP)

Plans not included:

• UnitedHealthcare Institutional Special Needs Plans (ISNP)
• UnitedHealthcare Institutional-Equivalent Special Needs Plans (IE-SNP)
• Any Medicare Advantage members included in a delegated risk agreement to provider medical groups (e.g., Optum Care Network)
• UnitedHealthcare commercial plans
• UnitedHealthcare Community Plans (Medicaid Only Plans)
• Long-Term Support Services (LTSS)

What happens next

You'll receive an email invitation to attend a provider education session. Attending the session will help ensure a smooth transition for you, your teams and our members.

To learn more about naviHealth and the UnitedHealthcare partnership, visit navihealth.com/united-provider-info. Please bookmark this site and check back frequently. Ongoing updates will be posted.

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