Meridian - September 2021 News, Handouts, and NEW authorization processes for Ambetter

September 29, 2021

September 2021 IInformation from Meridian Health regarding theeir product lines of business:

 

The Michigan Market temporarily suspending  Authorizations for Discharge to SNF as a response to hospitals being overwhelmed with COVID-19 in Michigan.  This solution will be put into place 9/27/2021 until through 10/28/2021, and then will be reevaluated. 

1. For CMU for MMP, Ambetter and Medicare

  • We approve a 3-day LOS initially and require the ACF to provide notification of the transfer.
  • CMU would conduct a medical necessity review on day 3 to allow 48 -hour NONMC delivery.

2. Medicaid

  • We approve a 5-day LOS initially and require the ACF to provide notification of the transfer.
  • Medicaid UM will conduct a medical necessity review on day 5

In addition, Meridian has provided the additional newsletters:

  • Monthly Provider Update for August 2021
  • Michigan MEridian Service Area and Products Plans and Sample Cards
  • Ambetter Prior Authorization Approval Request Processes effective 10/1.2021