New Tools & Process Improvements to Simplify Prior Authorization November 5, 2026 Samaritan Health Plans is decreasing prior authorization (PA) requirements and implementing a new tool to make it easier for providers to understand when prior authorization is required and to support timely access to covered services. Applicable plans include all of Samaritan Health Plans: IHN-CCO, Samaritan Advantage and Commercial plans. Beginning Nov. 23, 2026, prior authorization requirements will change for certain outpatient in-network elective services. Please review the updated PA requirements before providing services to Samaritan Health Plans members. Inpatient admissions will continue to require review, with the exception of imminent labor and delivery admissions. Out-of-network services will also continue to require review. If the implementation date changes for any reason, you will be notified via email and on our provider website. Important: Prior Authorization and Benefit Coverage Are Not the Same A determination that prior authorization is not required does not mean that a service is automatically covered. Providers should verify the member’s eligibility and applicable benefit coverage before providing services. Prior authorization or a determination that prior authorization is not required is not a guarantee of payment. Questions? Watch for upcoming provider communications and website updates that will include: Introductions to new tools Changes to prior authorization requirements Training For additional questions, please email the Customer Service Team or call: 541-768-5207 or 888-435-2396.
