Removal of Outpatient Authorization Requirements for IBC and AmeriHealth HMO
Effective January 1, 2009, Magellan customers Independence Blue Cross and its affiliates (IBC) and AmeriHealth HMO and its affiliates (AmeriHealth) made a change in policy designed to have a significant positive impact on providers of outpatient behavioral health services in the IBC and AmeriHealth service areas.
For members enrolled in the majority of IBC’s managed care plans, in addition to those enrolled in most AmeriHealth managed care plans in Pennsylvania and Delaware, prior authorization is no longer required for 1) routine outpatient mental health treatment, or 2) medication management sessions.
Previous requirements for providers to obtain initial and continuing mental health outpatient authorizations from Magellan for these services were discontinued as of January 1, 2009.
It is important to note that authorizations are still required for:
- Members enrolled in AmeriHealth New Jersey plans;
- Substance abuse outpatient treatment for all plans; and
- All higher levels of care, regardless of diagnosis, such as intensive outpatient and partial hospitalization services.
In November 2008, Magellan mailed out information packets to providers with detailed information on the specific benefit plans and mental health services impacted by the change. For additional information, refer to the IBC or AmeriHealth provider quick reference guides posted on this website.