The Idaho Medicaid outpatient behavioral health managed care carve-out approach is changing utilization of psychosocial rehabilitation services (PSR). In its new contract with Optum Idaho to administer the Idaho Behavioral Health Plan (IBHP) services, the Idaho Department of Health and Welfare (IDHW) required Optum Idaho to analyze all requests to initiate or continue outpatient PSR to determine if the services are medically necessary and in accordance with evidence-based practices. Under the state’s previous Medicaid fee-for-service system for outpatient behavioral health services, more than half of expenditures since 2011 were for PSR, with the majority of . . .