DVHA staff utilizes clinical criteria for making Utilization Review (UR) decisions that are objective and based on sound medical evidence. Approved criteria include the following:

• McKesson Health Solutions InterQual® Guidelines; 
• DVHA Clinical Guidelines; 
• Vermont State Medicaid Rules; 
• Hayes and Cochrane New Technology Assessments; and   
• Other Nationally Recognized Evidence Based Criteria. 

McKesson Health Solutions InterQual® Guidelines are available to providers on the Vermont Medicaid secure provider web portal at www.vtmedicaid.com/secure/logon.do . After log-in, look for the link McKesson Smart Sheets on the left window.