MedicaidPrior AuthMedium impact
Submission of prior authorizations for transplant surgeries
Oregon Health Plan·OR · Cardiothoracic Surgery, General Surgery, Nephrology +1 more·Plan contract
Effective date
Jun 5, 2024
We identified it
Jun 20, 2026
Summary
Oregon Health Authority has waived the requirement for Coordinated Care Organizations (CCOs) to submit transplant prior authorizations to OHA before performing surgeries. CCOs are no longer required to submit these PAs to the state authority, though other transplant-related contract requirements remain in effect.
Action Required
Immediately: Oregon-based practices working with CCOs should verify with their CCO partners that transplant prior authorization submission processes to OHA are no longer required. Update internal workflows to reflect that while CCO submission to OHA is waived, other transplant PA requirements may still apply per individual CCO contracts.