MedicaidPrior AuthHigh impact
ForwardHealth Update 2026-09: Prior Authorization Process Improvements: Revising the Prior Authorization Request Form, Vision Procedure Codes, and Prior Authorization RequirementsApril 17, 2026: This Update has been revised since its original publication. Information regarding the dental and orthodontic exception for PA requests requiring physical 3D models has been corrected on page 1 and 2.
Wisconsin ForwardHealth·WI · Optometry·Prior Authorization
Effective date
Jul 13, 2026
We identified it
Jun 18, 2026
Summary
ForwardHealth (Wisconsin Medicaid) is eliminating fax and mail prior authorization submissions effective July 13, 2026, requiring all PA requests be submitted electronically through their Portal. The policy also implements a universal 14-day backdating policy and removes certain vision procedure codes from PA requirements.
Action Required
By July 13, 2026: Billing team must establish ForwardHealth Provider Portal accounts and transition all prior authorization submissions from fax/mail to electronic submission only. Update workflows to ensure complete PA requests since incomplete submissions will be denied rather than returned. For vision services, stop requesting prior authorization for codes 92065, 92066, 92270, 92310, 92326, 92354, and 92355 effective April 13, 2026. Failure to submit electronically after July 13 will result in voided PA requests.