Care guidelines are important factors in medical necessity reviews of any services requiring authorization. ConnectiCare will be adopting the Milliman Care Guidelines effective May 1, 2019 for Connecticut plans and June 1, 2019 for Massachusetts plans. This change may affect prior authorization reviews, concurrent reviews and emergency inpatient admissions for our commercial and Medicare Advantage plan members.
You do not need to take any action. We will update our provider website, connecticare.com/providers, with the Milliman Care Guidelines on or around the effective date.