End of 1135 Waivers and Disaster Relief Flexibilities

Dear Georgia Medicaid and PeachCare for Kids Providers:

The national Public Health Emergency ended on May 11, 2023. As a result, the following 1135 waivers and disaster relief flexibilities have ended, and normal operations will resume:

• Temporary Suspension of Prior Authorization Requirements:
  • All Prior Authorization requirements and pre-approval requirements will resume effective immediately.
  • Prior Authorization requests that were approved on or after March 1, 2020 and automatically extended throughout the duration of the Public Health Emergency without a renewal must be re-authorized if the service is medically necessary and still required. 
• Suspension of Pre-Admission Screenings and Annual Resident Reviews (PASRR) Level I and Level II Assessments for 30 days:
  • All pre-admission screenings and annual resident reviews, Level I and Level II will resume effective immediately.
• State Fair Hearing Requests and Appeal Timelines:
  • The timelines for members to submit an appeal are reinstated effective immediately.

For the complete list, click here .