9/17/2011 | RESOURCES

MHCC Prior Authorization Best Standards

In 2011, Ai worked with the Maryland Health Care Commission (MHCC) to develop best standards for prior authorization, which is a process to determine in advance the medical necessity of certain care and services covered by insurance carriers. The process to develop best standards was informed by a workgroup, and documented in a final report that assessed legislation needs and also included a comprehensive literature review. Additional topics addressed included minimum technical specifications for web portals forms, key questions, and response times for prior authorization.