News and updates

Effective October 1, 2022, a prior authorization requirement will be added to Durable Medical Equipment (DME) that are not on OHA's fee schedule, are set to manual pricing, and/or are designated as...

These last few years of the COVID-19 pandemic have taught us not to take our health for granted. So it’s important to remember another virus—influenza (flu)—that comes along every year, and put the...

Updates on Existing CriteriaOctober 2022. The following changes to criteria are effective October 22, 2022: Prior Authorization Criteria –...

Pre authorization requirement update Effective August 29, 2022 pre authorization is required for codes 96116, 96121, 96132, 96133, 96136, 96137, and 96146 Please visit the authorization grid to...

Prior Authorization requirement on CPT 97010 - Effective 8/19/22

Updates on Existing CriteriaSeptember 2022. The following changes to criteria are effective September 22, 2022:Prior...

OHA distributed a news release on June 15th indicating that new rules made by the state Legislature’s passage of HB 2359 during the 2021 session related to use of qualified or certified health...

Dear Behavioral Health Providers, We want first to thank you for your continued care of our members. We have received several questions from our Behavioral Health provider partners requesting more...

Effective August 1, 2022, PacificSource will require prior authorization for Three-Dimensional (3D) Printed Orthopedic Implants. This change pertains to CPT codes 0559T, 0560T, and 0562T. Visit our...

Updates on Existing Criteria August 2022. The following changes to criteria are effective August 22, 2022: Prior Authorization Criteria – Clinical Updates...