Request for Retrospective PACER Review

PACER (Prior Authorization Certification, Evaluation and Review) is a telephonic review. MPRO assists the state in meeting its objective of assuring the admissions of Medicaid patients are:

• Medically necessary and to the appropriate setting
• Transfer to another facility is necessary in order to provide acute care services
  that are not available at the first facility
• Readmission within 15 days that is medically necessary, that is not a
  continuation of care from the first admit, and is not related to the prior
  admission
• Initial and continued stay of rehabilitation patients is medically necessary and
  appropriate

Download Request for PACER Review Form (PDF)