This past summer, United Healthcare and Humana both began delegating their skilled nursing facility prior authorization process to NaviHealth.
IHCA members have experienced a number of frustrating and time-consuming issues since NaviHealth took over this function, and the issues continue despite numerous meetings and frequent correspondence with NaviHealth.
AHCA recently met with CMS about these concerns and shared specific examples provided by IHCA members. AHCA reported back that the examples were eye-opening for CMS and that constructive discussion occurred during the meeting.
In order for AHCA to continue to advocate for greater oversight of NaviHealth, IHCA/INCAL members need to continue to share specific examples with this spreadsheet and email to eeichhorn@ihca.org.
Specific examples are critical for AHCA’s next meeting with CMS in early May to discuss next steps.