MedicaidPrior AuthHigh impact
1915(i) Community Based Integrated Supports (CBIS) Authorization Process
Oregon Health Plan·OR · Palliative Care, Psychiatry·Provider
Effective date
Oct 27, 2026
We identified it
Oct 10, 2026
Summary
Effective October 27, 2026, Oregon Health Authority is transitioning 1915(i) Community Based Integrated Supports (CBIS) billed under H0046 from Prior Authorization (PA) to Plan of Care (POC) authorization in MMIS. All existing PAs will end October 26, 2026, with remaining approved services automatically transferred to POC format starting October 27, 2026. New referrals will be entered directly as POC after IQA approval through the PCSP.
Action Required
By October 26, 2026: Billing team must stop submitting claims against MMIS Prior Authorizations for 1915(i) CBIS (H0046). Starting October 27, 2026: Billing team must submit all 1915(i) CBIS claims against MMIS Plan of Care (POC) authorization instead. Providers should complete the Registration Packet to access the Comagine Health Provider Portal (CHPP) before the transition date. Beginning October 27, 2026, OHA will only reimburse for services rendered on or after the POC approval date. Verify that the practice has updated billing workflows to recognize the new POC authorization format and confirm staff understand the transition from PA to POC authorization method in MMIS. Note: IQA (Comagine Health) will initiate annual reassessment 60 days prior to POC end date.