Assistance with Telephonic Prior Authorization for Enteral Nutrition

To assist providers to call enteral nutrition requests in telephonically, information regarding the policy for the medical necessity requirements for enteral nutrition is available in the medical supplier chapter of the Medicaid provider manual available at www.michigan.gov/medicaidproviders.

Please see the formula request link for information on oral and tube feeding administration which may be requested during the telephonic review. No physician signature is required as the reviews are telephonic. Documentation is required to be on file in the beneficiary’s clinical record.

Oral Formula Request (PDF)

Tube Feeding Formula REquest (PDF)