MedicaidPrior AuthMedium impact
MSA 21-23
Michigan Medicaid - MDHHS·MI · Cardiology, Internal Medicine·Provider Bulletin
Effective date
Aug 1, 2021
We identified it
Jun 20, 2026
Summary
Michigan Medicaid has updated prior authorization requirements for wearable cardioverter defibrillators (WCDs), limiting approvals to 60-day periods with a maximum of four months total coverage. Compliance download data is now required for second authorization periods, and extensions beyond four months will only be approved monthly on a case-by-case basis.
Action Required
By August 1, 2021: Billing and prior authorization teams must update WCD authorization workflows to request 60-day periods instead of longer durations. Ensure compliance download data is collected and submitted with requests for second authorization periods (minimum 45 days wear time data required). Update tracking systems to monitor the four-month maximum coverage limit and prepare monthly authorization requests for extensions beyond four months.