MedicaidAdministrativeMedium impact
Comagine Health is the Oregon Behavioral Health Independent Qualified Agent effective July 1, 2020
Oregon Health Plan·OR · Psychiatry, General Practice·Provider
Effective date
Jul 1, 2020
We identified it
Jun 20, 2026
Summary
Effective July 1, 2020, Comagine Health replaces KEPRO Inc. as Oregon's Independent Qualified Agent (IQA) for behavioral health services. Comagine Health will handle prior authorizations, utilization review, and eligibility determinations for fee-for-service behavioral health services. Providers should continue submitting authorizations to KEPRO until the transition is complete.
Action Required
By June 30, 2020: Billing team must prepare to transition all behavioral health prior authorization submissions from KEPRO Inc. to Comagine Health, effective July 1, 2020. Until June 30, 2020: Continue directing all fee-for-service behavioral health service authorizations to KEPRO. Starting July 1, 2020: Update billing software, prior auth submission processes, and provider contact lists to route all behavioral health authorizations, utilization reviews, and 1915(i) eligibility determinations to Comagine Health. Notify all clinical and administrative staff of the IQA transition. Failure to submit to the correct IQA after July 1, 2020 may result in claim denials or processing delays. Monitor for additional Comagine Health communications (expected May 2020) detailing policies, procedures, and transition details. Contact Alise Campbell (alise.v.campbell@dhsoha.state.or.us, 503-983-6080) with questions.