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Page 45 Wisconsin BadgerCare Reform Demonstration Approval Period: October 29, 2024 through December 31, 2029

requested treatment is at the appropriate level of care. Managed care organizations contracted with Wisconsin Medicaid can make decisions to provide or deny services on the basis of medical necessity and place appropriate limits on a service for the purpose of utilization management, but cannot define medical necessity in a way that is more restrictive than the definition used by Wisconsin Medicaid. authorization guidelines for initial admittance to residential treatment and authorization guidelines for continued stays in residential treatment.