MEMBERSHIP MATTERS

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• MA plans’ prior authorization approvals must remain valid for the duration of the course of treatment.

• MA plans must provide beneficiaries with a 90-day transition period where a PA would remain valid for any ongoing course of treatment when beneficiaries change plans or enter MA.

• After PA approval, MA plans cannot retroactively deny coverage for a lack of medical necessity.

• HOW YOU CAN HELP: Share your unique experience as a patient, physician or health care professional so we can fight back to ensure California policy puts patients first. https://www.cmadocs.org/survey/testcd/CMA_PRIORAUTH/ cd/-1

What physicians need to know about the end of the COVID-19 state of emergency

See: CMADocs.org

After three years of pandemic operations, both the State of California and the federal government are winding down the COVID-19 public health emergency. California’s State of Emergency ends on Tuesday, February 28, 2023, while the federal public health emergency is scheduled to expire on Thursday, May 11, 2023. CMA has published a guide – End of the COVID-19 Emergency: What Physicians Need to Know – to help physicians navigate the end of the state’s emergency authority.

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