R414-515-5. Service Coverage

  (1) An LTAC provider must submit to the Department a request for coverage that includes current and comprehensive documentation, or the Department will return the request as incomplete.

  (2) The Department shall consider LTAC coverage upon the date it receives the request and current, comprehensive documentation.

  (3) The Department shall review the documentation to determine preadmission, continued stay, or retroactive stay within three business days of the request.

  (4) Prior authorization is not transferable from one LTAC to another.

  (5) Prior authorization is required for preadmission, continued stay, and retroactive reviews.

  (6) If a member transfers from an LTAC to an acute care hospital for any reason, and is away from the LTAC for greater than 24 hours, the LTAC shall submit a new preadmission review before transferring the member back to the LTAC.

  (7) Each approved prior authorization is for a seven-day period.