WHO WE SERVE
Independent Review Services for Government Programs
medlitix supports federal and state government agencies with URAC-accredited clinical review services — delivering accurate, compliant, and timely determinations across Medicaid, Medicare, and other government health programs.
What's included
Medicaid Program Reviews
Clinical review services addressing Medicaid benefits coverage issues requiring highly complex and technical decisions across state managed care programs.
Medicare Reviews
Independent review services supporting Medicare Advantage and Part D programs including prior authorization and appeal determinations.
ACA Exchange Reviews
State-contracted external review services for final binding appeal determinations for group health insurance plans and individual market issuers.
Preferred Drug List Ratification
Expert pharmacy reviews guaranteeing that Medical Assistance program beneficiaries receive clinically effective pharmaceutical care focused on quality, safety, and optimal outcomes.
State External Review Programs
Contracted with Departments of Insurance in multiple states to support state-mandated external review programs with full regulatory compliance.
Federal Agency Support
Clinical review services for HHS, Department of Labor and Treasury supporting ACA compliance, appeals administration and coverage determinations.
Who we serve
medlitix partners with federal and state agencies administering government health programs nationwide.
→ State Medicaid Agencies
→ Medicare Advantage Plans
→ State Departments of Insurance
→ Federal Health Agencies
Why government agencies choose Medlitix
URAC-accredited IRO
Active state DOI contracts
Full regulatory compliance
Experienced federal program team
Ready to streamline your review process?
Submit a referral today or reach out to explore how medlitix can support your team.