Providers

Medical Policy Upcoming Updates

Notification Date: January 19, 2022

Below are the policies that are new or have been reviewed, along with the determination and summary of any changes.

Coverage Policies

Policy Title	Status	Effective Date	Determination	Summary of Change
MCG Care Guidelines^®	Re-Reviewed	On or after 03/21/2022	Medically necessary for a select population of patients	Medica may use tools developed by third parties, such as MCG Care Guidelines^®, to assist in administering health benefits. Medica will begin using the 26^th edition of MCG Care Guidelines on or after March 21, 2022.

The updated clinical policies and guidelines above will be available as of their effective date, as noted. View policies and guidelines.

To request paper copies of a policy, please leave a message at the Medica Provider Literature Request Line: 1-800-458-5512, option 1, then option 8, then ext. 2-2355.

Where information conflicts with applicable state and/or federal law, Medica follows such applicable federal and/or state law.