Rep. TJ Cox asks federal government to give states more flexibility during coronavirus emergency

By The Leader Staff
Rep. TJ Cox
Rep. TJ Cox

This week the U.S. Department of Health & Human Services granted California several key waivers under federal Section 1135 through the duration of the COVID-19 emergency. 

Kings County Representative TJ Cox, and his colleagues, asked the federal government to provide states, especially California, more flexibility to provide the best, most timely care during the coronavirus emergency. 

 The waiver in question includes these provisions: 

  • Temporarily suspend Medicaid fee-for-service prior authorization requirements. Section 1135(b)(1)(C) allows for a waiver or modification of pre-approval requirements, including prior authorization processes required under the State Plan for particular benefits. 
  • Extend pre-existing authorizations for which a beneficiary has previously received prior authorization 
  • Extend state fair hearing requests and appeal timelines 
  • Ease requirements for enrollment of providers in MediCal 
  • Expand the locations where covered procedures can occur

"Our chances of getting through this crisis hinge on whether quality health care is available as quickly as possible to everyone in the Central Valley in order to meet the demands of this emergency," said Cox. "We need to give the states regulatory relief so that they can effectively care for their most vulnerable citizens."

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