Defining Medical Necessity: Strategies for Promoting Access to Quality Care for Persons with Developmental Disabilities, Mental Retardation, and Other Special Health Care Needs. Executive Summary

This report summary discusses how inadequate definitions of medical necessity by managed care organizations may lead to denial of care. It outlines a strategy for defining medical necessity to ensure access to quality health care for persons with developmental disabilities, mental retardation, genetic disorders, and other special health care needs.