IMPORTANT NOTICE: ACTION REQUIRED Georgia Families Ending of 45 Day Prior Authorization Period July 1, 2017 through August 14, 2017
If you are rendering services to a Georgia Families® Member who has a newly assigned CMO effective July 1, 2017, the newly assigned CMO will honor any current/open Prior Authorizations beginning on July 1, 2017 through August 14, 2017. This includes current/open Prior Authorizations issued to providers who are both contracted and not contracted (non-par) with the newly assigned CMO. Please ensure that you have contacted the new CMO to coordinate the Member’s care before August 14, 2017.
If the Member requires services after August 14, 2017, Providers must contact the Member’s new CMO to obtain an authorization, if required, to continue those services. If a Member is receiving a medication that is not on the new CMO’s Preferred Drug List (PDL), please contact the new CMO to make arrangements for the provision of medication post August 14, 2017.
Beginning August 15, 2017, Providers will be required to follow each CMO’s prior authorization process and guidelines for any services the Member needs. This applies to in-network and out-of-network (non-par) Providers. Prior Authorization decisions for non-urgent services will be made within three (3) business days. Expedited service authorization decisions will be made within twenty-four (24) hours.