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Medical Prior Authorization List

April 15, 2016

These requirements are administered by Health First Health Plans (“Health Plans”). Benefits are determined by the plan. Items listed may have limited coverage, or not be covered at all. All items and services on this list require prior authorization, regardless of the service location, plan type, or provider participation status.

Spotlight

Maine Medical Center

Maine Medical Center (MMC) is a complete health care resource for the people of Greater Portland and the entire state, as well as northern New England. Incorporated in 1864, MMC is the state's largest medical center, licensed for 637 beds and employing more than 6,000 people. MMC's unique role as both a community hospital and a referral center requires an unparalleled depth and breadth of services, including an active educational program and a world-class biomedical research center. As a nonprofit institution, Maine Medical Center provides nearly 23 percent of all the charity care delivered in Maine. MMC is a member of the MaineHealth system, a growing family of health care services in southern, central, and western Maine

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Medical Prior Authorization List