Prior Authorization Criteria Care Guidelines

Samaritan Health Plans utilizes the Care Guidelines to determine medical necessity. The Guidelines are the protected intellectual property of MCG. Samaritan Health Plans is not able to distribute them without the permission of MCG. MCG has provided a tool that allows Samaritan Health Plans members and prospective members to view relevant MCG guidelines, however you will not be able to print them.

To view MCG Guidelines click below and follow the instructions:

Step 1: Access Guidelines, read the disclaimer and accept the terms and conditions.
Step 2: Complete the User information form.
Step 3: Complete the verification process to continue.
Step 4: Click on the arrow icon.
Step 5: Click on the guidelines you wish to view.