Medical Necessity and Clinical Criteria

McLaren Medicare partners with InterQual® to create clinical criteria or standards to determine the medical necessity and appropriateness of health care services.

Clinical criteria help ensure that health care services are evidence based and objective. Clinical criteria are not used to deny care. Clinical criteria can help improve health outcomes and may also help reduce the cost of services.

The following procedures are subject to InterQual clinical criteria guidelines. Refer to InterQual® for the below clinical criteria guidelines... https://prod.ds.interqual.com/service/connect/transparency?tid=dc31b123-941a-4127-a79e-44d2eb3980d5

  • Abdomen CT scan with/without contrast
  • Bariatric revision
  • CardioMems
  • Electrical Stimulation
  • Entropion Repair
  • Erector Spine Block
  • External wearable defibrillator
  • Sex Reassignment/Affirmation*
  • Heart (cardiac) cath
  • Intracranial neurostimulator electrode removal/replacement
  • Keratoplasty corneal transplant
  • Nuclear Medicine Myocardial Perfusion Study (rest/stress scan)
  • Outpatient therapy (Physical, Occupational, and Speech Therapies)
  • Panniculectomy/Abdominoplasty
  • Pelvis CT scan with/without contrast
  • Peroral Endoscopic Myotomy
  • Transthoracic Echocardiography

*World Professional Association for Transgender Health (WPATH) criteria may be used in addition to InterQual criteria. WPATH criteria are listed here: https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644

Additional Information and Resources

Medicare Prior Authorization list:
mclarenhealthplan.org/Uploads/Public/Documents/HealthPlan/documents/Medicare/MHP_Medicare_PriorAuthorizationList.pdf

Utilization Management Annual Reporting

The Centers for Medicare and Medicaid Services (CMS) requires health plans to publish certain utilization data on their website for members and providers.  Utilization data is related to how quickly we process authorization requests. The required data is presented in the table below: (2025 Data Coming Soon)

Item Calendar Year
2025
Total standard prior authorization requests received  
Total expedited prior authorization requests received  
Total standard and expedited prior authorization requests received  
Percentage of standard prior authorization requests that were approved  
Percentage of standard prior authorization requests that were denied  
Percentage of standard prior authorization requests approved after appeal  
Average time to decision for standard prior authorizations  
Median time to decision on standard prior authorizations  
Percentage of expedited prior authorization requests that were approved  
Percentage of expedited prior authorization requests that were denied  
Average time to decision for expedited prior authorizations  
Median time to decision for expedited prior authorizations  
Percentage of total prior authorization requests approved with an extended timeframe