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Governor Holcomb issues Executive Order to Extend Temporary Health Care Licensure, Requires Hospital Elective Changes, and Seeks Waiver of Prior Authorization from Insurers

Posted Sep 30, 20213 min Read

Regulatory & Clinical

On September 30, 2021, Governor Eric Holcomb issued Executive Order 21-27, which extends most provisions of previous E.O.s 21-17, 21-19, 21-23 and 21-24.  This E.O. 21-27 also continues provisions concerning hospital elective procedures and requests of insurers to suspend Prior Authorization requirements for these procedures and to facilitate hospital-to-post acute transfers.  Below are the key provisions:

Licensure and Scope

  • Extension of the temporary health care licensing authorities through December 31, 2021;
  • Provisions permitting expedited registration requirements for out-of-state health care providers;
  • Provisions regarding insurance coverage for out-of-state health care providers; and
  • Expansion of individuals permitted to administer COVID-19 immunization and PREP Act immunity for providing those vaccinations.

Advance Practice Registered Nurses

An APRN is permitted to provide services in multiple locations as long as they have a collaborative agreement on file. The relevant provisions in IC 25-23-1-19.4 and 848 IAC 5-1-1(a)(7)(F) are suspended.

Hospital Electives and Reporting

E.O. 21-24 also directs hospitals, when necessary, reprioritize or postpone non-emergent procedures or surgeries, and consult the best practices and recommendations from their industry in making this assessment.  In addition, hospitals are required to report the following to IDH’s EMResources system:

  • Diversion status, as directed by IDOH.
  • Number of hours spent in diversion for Emergency Departments and critical care units for the previous day, on a daily basis.
  • All information required by the Department of Health and Human Services, including number of available beds, ICU beds, pediatric beds, pediatric ICU beds, and ventilator availability, on a daily basis.

Insurance Prior Authorization

E.O. 21-24 directs the Commissioner of the Indiana Department of Insurance to request that insurers do the following:

  • To extend PA timeframes for open and approved authorizations for non-emergent surgeries or procedures postponed to ensure sufficient COVID-19 response only; and
  • To waive clinical information requirements for PAs for transfers and discharges of patients from hospitals to post-acute placement and home-based placement.

More information on the results of the IDOI request of insurers to waive the PA requirements will come and will impact the hospital-to-post acute transfer process.

COVID-19 Control Measures for Institutions

IDH issued a document concerning COVID-19 Control Measures for institutions such as schools, prisons, child care facilities, and congregate care facilities.  The document includes long-term facilities, but other existing guidance to long-term care facilities is more detailed.  Still, long-term care facilities should review this document and incorporate as needed to ensure proper reporting and investigation of COVID-19 cases occurs.



About the Author

Zach Cattell, President, Indiana Health Care Association