MedicaidAdministrativeMedium impact
Training requirement for CCO SUD Utilization Management Staff
Oregon Health Plan·OR · Psychiatry, Family Medicine, Internal Medicine·Plan contract
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority now requires Coordinated Care Organizations (CCOs) to annually report the qualifications and training of utilization management staff who make substance use disorder (SUD) treatment authorization decisions. Staff must have working knowledge of ASAM Criteria, DSM criteria, and SUD treatment to make appropriate level-of-care determinations.
Action Required
By 2023 contract year: CCOs must ensure their utilization management staff and subcontractors who make SUD treatment authorization decisions have adequate training in ASAM Criteria, DSM criteria, and SUD. Complete annual reporting of staff qualifications, training, experience, and credentials as outlined in Section 23 of Exhibit M in the 2023 CCO contract. Consider enrolling UM staff in the recommended ASAM Criteria Utilization Management Course.