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MedicaidPrior AuthMedium impact

Prior authorization requirement for Intensive In-Home Behavioral Health Treatment (IIBHT)

Oregon Health Plan·OR · Psychiatry, Pediatrics·Plan contract
Effective date
May 4, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority is immediately deferring enforcement of prior authorization requirements for Intensive In-Home Behavioral Health Treatment (IIBHT) and will permanently remove these requirements. Providers must stop sending prior authorization requests for IIBHT services to Comagine or CCOs effective immediately.

Action Required

Action needed
Immediately: Stop sending prior authorization requests for IIBHT services to OHA's third-party contractor Comagine or member CCOs. This applies to previously submitted PA requests as well. Billing team should update workflows to remove prior auth requirements for IIBHT services for Oregon Medicaid patients.