MedicaidPrior AuthHigh impact
Technical assistance for Behavior Rehabilitation Services prior authorization processes effective June 1, 2024
Oregon Health Plan·OR · Psychiatry·Community partner
Effective date
Jun 1, 2024
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is implementing new prior authorization processes for Behavior Rehabilitation Services (BRS) under Medicaid effective June 1, 2024. All BRS services now require prior authorization reviewed by Licensed Practitioners through contracted Comagine Health to ensure medical necessity and appropriate use of Medicaid funds.
Action Required
By June 1, 2024: Billing team must implement prior authorization requirements for all Behavior Rehabilitation Services (BRS) for Oregon Medicaid patients. Update billing system to flag BRS services for prior auth verification before submission. Train staff on new authorization process through Comagine Health. Failure to obtain prior authorization will result in Medicaid claim denials for BRS services.