Retracting Prior Authorization for claims related to the AEM program

HCA Apple Health


The Health Care Authority (agency) sent a notice to providers on October 14, 2015, requiring a prior authorization number for all claims related to the Alien Emergency Medical (AEM) program. 

Effective immediately, the agency is retracting this requirement. The agency no longer requires prior authorization for claims related to AEM.

Reminder!  The AEM program has a very limited benefit.  All services must be directly related to the treatment of the qualifying emergent diagnosis.  The agency is drafting an AEM Provider Guide, which will include additional billing information.  This guide will be available by April 1, 2016, for download on the agency’s Provider Guides website.