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MAMES seeks feedback on prior auth delays 

MAMES seeks feedback on prior auth delays 

MADISON, Wis. – MAMES requests examples from Michigan-based providers on situations were a prior authorization submitted for a traditionally non-covered item required more information, causing delays in patient access. As of Aug. 1, 2020, Wisconsin Medicaid removed the list of non-covered items from the DME service area of the Online Handbook in accordance with a federal statute. Since then, the MAMES Insurance Committee has been working on issues related to this change and has shared its feedback with ForwardHealth, which provides a web portal for the state’s Medicaid program. The state’s Department of Human Resources recently told MAMES: “FH will work to be transparent on the items and coverage criteria, however, cannot in good faith, provide coverage criteria for each individual piece of equipment that is available or becomes available in the consumer market. FH will review every case that comes in with efficiency and integrity, while working to get a timely response to providers and members about the outcomes and coverage of all equipment being submitted for review.”  Please send examples to the MAMES office, [email protected] 

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