Idaho Medicaid: New prior authorization requirements for radiation therapy

Beginning Jan. 1, 2026, we’ll require prior authorization and notifications for outpatient chemotherapy and radiation therapy services for members enrolled in the Idaho Medicare Medicaid Coordinated Plan (MMCP). You can continue to submit these requests through the Optum® Cancer Guidance Program (CGP), which aligns with MMCP and our existing processes for oncology.

Radiation therapy services requiring prior authorization

Beginning Jan. 1, 2026, we’ll require prior authorization and notification for the following radiation therapy services:

• Intensity modulated radiation therapy
• Proton beam therapy
• Stereotactic body radiation therapy
• Fractions for breast, prostate, lung cancer and bone metastasis
• Image guided radiation therapy
• Special and associated radiation therapy services

This expansion is part of the CGP, a comprehensive approach to managing oncology service requests.

How to submit a prior authorization

• Sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID
  • If you don’t have a One Healthcare ID, register now
• From the left-hand tabs, select Prior Authorizations & Notifications

For training, view our Prior Authorization and Notification interactive guide.

Coverage guidelines and payment

For more information, view our coverage determination guidelines for radiation therapy services.

Keep in mind, an approved prior authorization doesn’t guarantee payment. Payment is subject to member eligibility, benefit plan details, claim processing requirements and provider participation terms.

Resources

For additional program information and live training, please visit our Oncology Prior Authorization and Notification resources.

Questions? We’re here to help.

If you have questions, please call 888-397-8129 or email unitedoncology@uhc.com.