meridian_health_plan_of_michigan policy updates
Track new and updated meridian_health_plan_of_michigan policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Actimmune (interferon gamma-1b) — Prior Authorization and Coverage Criteria | Meridian Health Plan Of Michigan | Clinical | Immunology/Rheumatology | Modified | Aug 1, 2026 |
| 2026 Step Therapy Criteria — Pharmacy step edits for behavioral health drugs | Meridian Health Plan Of Michigan | Clinical | Pharmacy & Specialty Drugs | Modified | Aug 1, 2026 |
| Medicaid appeal process and deeming-period coverage | Meridian Health Plan Of Michigan | Administrative | — | Modified | Jul 1, 2026 |
| Oral Antipsychotics Step Therapy (ANTIPSYCHOTICS - ORAL - PST) | Meridian Health Plan Of Michigan | Clinical | Pharmacy & Specialty Drugs | Modified | Jan 1, 2025 |
| Musculoskeletal (MSK) Management Program prior authorization | Meridian Health Plan Of Michigan | Clinical | Orthopedics/Musculoskeletal | Modified | Apr 1, 2024 |
| Meals and Lodging Reimbursement | Meridian Health Plan Of Michigan | Reimbursement | — | Modified | Jan 1, 2024 |
| Inappropriate Primary Diagnosis — Denials for Unacceptable Primary/Principal, Manifestation, and Sequela Diagnoses | Meridian Health Plan Of Michigan | Reimbursement | — | Modified | Aug 1, 2023 |
| Resumption of medical necessity review for inpatient admissions | Meridian Health Plan Of Michigan | Clinical | Post-Acute & Facility Care | Modified | Jul 5, 2023 |
| Termination of Somatus Care Management Program for Patients with CKD/ESRD | Meridian Health Plan Of Michigan | Administrative | — | Modified | Jul 1, 2023 |
| Inpatient admission notification to Utilization Management | Meridian Health Plan Of Michigan | Administrative | — | Modified | May 5, 2023 |
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Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.