MedicaidPrior AuthMedium impact
Idaho Medicaid: New prior authorization requirements for radiation services
UnitedHealthcare·ID · Oncology, Radiology·State news
Effective date
Jan 1, 2026
We identified it
Jan 12, 2026
Summary
Starting January 1, 2026, Idaho Medicaid Medicare Coordinated Plan (MMCP) will require prior authorization for outpatient radiation therapy services including intensity modulated radiation therapy, proton beam therapy, stereotactic body radiation therapy, and image guided radiation therapy. Providers must submit requests through the UnitedHealthcare Provider Portal via the Optum Cancer Guidance Program.
Action Required
By January 1, 2026: Billing team must update systems to require prior authorization for all radiation therapy services for Idaho MMCP members. Train staff to submit prior auth requests through UnitedHealthcare Provider Portal using One Healthcare ID. Update encounter forms to remind providers that prior authorization is required. Claims will be subject to denial without proper authorization.