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Provider News View Changes to Prior Authorization Requirements for 2018

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Article updated February 16, 2018

New Prior Authorization requirements went into effect starting Jan. 1, 2018, for in-network providers who have patients that are members of Samaritan Advantage, Samaritan Choice, Commercial Groups and InterCommunity Health Network Coordinated Care Organization (IHN-CCO). 

Health Plans has made changes to Prior Authorization requirements thanks to some feedback we have received from our provider network. Now, providers will no longer be required to submit Prior Authorizations for:

  • In-network behavioral health outpatient services for IHN-CCO members
  • Durable medical equipment billed at less than $150 for IHN-CCO members
  • CT scans (see Prior Authorization Lists for exceptions)
  • Some in-network elective procedures 

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