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Medicaid UR Review Types:
Home Health Care

Medicaid provides for skilled, intermittent, and medically necessary home health services for eligible recipients. The focus of home health services is to assist the recipient in returning to an optimum level of functionality. Prior approval is required.

Request home health care services on form MAD 301. The completed form must be accompanied by the plan of care for the certification period and any pertinent medical records. Recipients must have a medical need to receive care at home, and must be certified as such by their attending physicians. To be considered eligible for coverage, home health care services must be skilled, intermittent, and medically necessary. For initial certifications, requests must be received at Medicaid UR within 10 calendar days of the start of care; requests for certification must be received before expiration of the current authorization.

 

 

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