Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

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Medical necessity criteria updates to occur in September

The 2021-2022 Magellan Care Guidelines will become effective Sept. 2, 2021. This is a delay from our regularly scheduled update on July 1. Stay tuned to our provider website, MagellanProvider.com, for its release. The 2020-2021 Magellan Care Guidelines will remain in effect until Sept. 1 this year.

Magellan uses the most recent edition of the MCG Guidelines® (“MCG”) in addition to Magellan’s proprietary clinical criteria (“Magellan Healthcare Guidelines”) as the primary decision support tools for its Utilization Management Program. 

Note that criteria for some levels of care, plans and states differ. Please visit our Medical Necessity Criteria webpage for more information.

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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