Dec. 6, 2018

The Federal Employee Program (FEP) has updated its list of services that require prior approval for the 2019 FEP Blue Focus Plan. The list includes services for inpatient hospital admissions and other services. A portion of the list includes:

• Gene Therapy and Cellular Immunotherapy
• Air Ambulance Transport (non-emergent)
• Applied Behavior Analysis (ABA) 
• Genetic Testing 
• Surgical Services

For a complete list of the FEP Blue Focus services that require prior approval, see pages 19-25 of the FEP Blue Focus Plan Brochure. (This link leads to a third party site. That site is solely responsible for the contents and privacy policies on its site.) Please remember medical necessity is not a guarantee of payment. Payment is subject to the member’s plan coverage, to include prior authorization requirements and benefits, at the time the service is performed. You can contact Provider Education by using the Provider Education Contact Form or by calling 803-264-4730 with additional questions.