Community Behavioral Health Did Not Comply With Requirements When Denying Prior Authorization Requests

In June 2026, the Office of Inspector General (OIG) identified challenges that might reduce the quality of behavioral health care services provided to individuals enrolled in Medicaid. The audit is part of a series of OIG audits examining Medicaid managed care organization (MCO) denials, including work examining the use of prior authorizations that may result in delays for enrollees seeking to access behavioral health services. The objective was to determine whether Community Behavioral Health (CBH) complied with Federal and State requirements when it denied requested behavioral health services that required a prior authorization. Findings included that CBH did not comply . . .