Renewal of Federal PHE Allows State to Continue Pediatric Shift Nursing “Freeze”

State officials confirmed at a recent public meeting that the Department of Human Services (DHS), with the extension of the federal Public Health Emergency, would continue the protections currently in place for pediatric skilled nursing services.  The federal Public Health Emergency was renewed for another 90 days on July 23, 2020.   

As part of its response to the COVID-19 emergency, DHS in early April removed prior authorization requirements for certain services and effectively “froze” existing authorizations for in-home pediatric skilled nursing services.  According to this guidance, shift nursing authorizations in place as of early April are continued at the same level of hours until further notice from DHS.  New requests for services and requests for additional hours are not covered by this guidance and still require prior authorization.  Any shift nursing requests newly approved since April are covered by these protections. 

In taking this action to suspend prior authorization requirements, DHS is exercising authority temporarily available through federal approval of its 1135 Waiver requests.  The ability to waive or modify normal requirements under this section of the Medicaid Act depends upon a federal Public Health Emergency being in effect.   

Families or advocates with questions regarding these shift nursing protections should contact our Helpline at (800) 274-3258.