Medicaid Implements Universal Prior Auth Forms

Thursday, July 02, 2020 10:41 AM | Sydney Maras (Administrator)

This week, IMS efforts to streamline the Medicaid managed care system took another step forward with implementation of a set of universal prior authorization applications that can be utilized for both MCOs and the fee-for-service program. The result of a 2019 IMS-authored legislative directive, these universal forms are intended to address an aspect of the administrative burden many practices have reported since the state transitioned to managed care.

The state is taking a phased implementation approach to allow practices time to transition to the universal applications. Until October 1, practices may continue to utilize the MCO-specific applications; they may also begin utilizing the new universal application forms. After October 1, practices must have transitioned to the new universal forms for all Medicaid prior authorizations.

More information on the new forms is included in a new Informational Letter which was released this week. IMS continues to work on additional steps to address issues within the Medicaid managed care system. For individual assistance with Medicaid issues or more information on these efforts, please contact Dennis Tibben with the IMS Center for Physician Advocacy.


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