MedicaidPrior AuthMedium impact
HCBS300 - Medicare Medicaid Coordinated Plan and Blue Cross of Idaho Medicaid Plus Prior Authorizations - Updated services. Care Coordination process changes.
Blue Cross of Idaho·ID·Medical Policy
Effective date
Dec 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Medicare Medicaid Coordinated Plan and Medicaid Plus prior authorization requirements for home and community-based services (HCBS). The policy clarifies that prior authorization must be obtained through the member's care coordinator before rendering long-term support services, with services rendered without authorization potentially resulting in nonpayment.
Action Required
Immediately: Billing team must verify prior authorization is in place before rendering any long-term support services listed in the policy for Medicare Medicaid Coordinated Plan and Blue Cross Idaho Medicaid Plus members. Contact the member's care coordination team (per HCBS101) to request authorization changes. Check authorization status at providers.bcidaho.com before service delivery. Claims submitted without prior authorization may be denied.