Transcription of Managed Care Operations Memorandum General …
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Managed care Operations Memorandum General Operations MCOPS Memo # 07/2016-008 DATE: July, 22, 2016 SUBJECT: Guidance Regarding the Review of Requests for Skilled Nursing, Personal care Services, Including that Provided by Home Health Aides TO: All HealthChoices PH-MCOs care Organizations Statewide FROM: Laurie Rock, Director, Bureau of Managed care Operations Purpose: To provide guidance to the Physical Health Managed care Organizations (PH-MCOs) regarding prior authorization policies and the review of requests for skilled nursing and personal care services, including services provided by home health aides, for members under the age of twenty-one (21). Background: MC Ops Memo #MCS-07/2010-014, Policies Concerning Medical Necessity Determinations for In-Home and Community services, was issued on July 10, 2010.
Managed Care Operations Memorandum General Operations MCOPS Memo # 07/2016-008 DATE: July, 22, 2016 SUBJECT: Guidance Regarding the Review of Requests for Skilled Nursing, Personal Care
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