Datapoint: Point32Health Nixes Home Care Utilization Management

Starting on April 12, Point32Health will not require utilization management for home care services for nearly all members in commercial plans during the first 30 days after discharge from a hospital. The insurer, whose affiliates are Harvard Pilgrim Health Care and Tufts Health Plan, announced the change in an April 2 press release. The company said it will continue to require prior authorization after the initial 30 days post-discharge for home care services, including physical therapy, occupational therapy, home health aides and nutritional counseling. Point32Health currently serves 668,575 commercial risk-based members in five New England states, plus an additional 636,785 members via self-funded arrangements.

Source: AIS’s Directory of Health Plans

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AIS Health Staff

AIS Health Staff

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