As we work together to stop the spread of COVID-19 at home, work and in the community, we want to make sure you have the resources you need to keep informed, healthy and safe. If you have any questions about OHP and COVID-19, please let us know.
Updates for Oregon Health Plan providers
NEMT stretcher van transports during the COVID-19 emergency - Effective immediately, the Oregon Health Authority (OHA) will allow stretcher vans to provide ground non-emergency medical transportation (NEMT) that ambulance services would normally provide during the COVID-19 Public Health Emergency, unless the ordering provider/discharging facility deems ambulance service medically necessary for patient safety.
While the decisions regarding medical necessity and appropriate use of limited EMS resources lie ultimately with the discharging facility, patient safety remains the top priority.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to Oregon Health Plan (OHP) coverage of testing, screening, treatment and telemedicine services; OHP eligibility; and other information and resources related to providing and billing for covered services during COVID-19.
- The guide now contains all billable codes for COVID-19 testing and incorporates recent guidance related to testing, NEMT and home blood pressure monitoring.
Updates for all health care providers
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Provider compliance and collaboration with Comagine Health
As of July 1, 2020, Comagine Health is OHA's Independent and Qualified Agent (IQA) for 1915(i) Home and Community Based Services and is responsible to perform federally required work on behalf of OHA.
For the IQA to fulfill its role and responsibilities, it is critical that providers collaborate with Comagine Health and comply with Comagine Health’s requests for information and documentation.
This will ensure that providers are compliant with federal regulations and OARs, remove barriers to processing authorizations of services, and help providers receive timely payments.
To learn more about how to work with Comagine Health to ensure timely processing of requests and referrals for behavioral health services, please read OHA's December 9 memo.
Save the date: 2021 Visual Services collaboratives
To promote understanding of OHP's fee-for-service Visual Services policies and coverage, OHA will start holding quarterly virtual collaboratives in 2021.
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Day and time: Tuesdays, 10 to 11:30 a.m.
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Dates: March 9, June 8, September 7 and December 7, 2021
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Location: Virtual meeting, platform to be determined
Coordinated care organizations, providers, and any other health care partners interested in ensuring appropriate access to visual services are encouraged to attend.
If you are interested in joining, please express your interest via email to both napuaann.k.rich@dhsoha.state.or.us and shannon.d.jasper@dhsoha.state.or.us.
Recent rule revisions
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OAR 410-120-1396 - Updates to Improve Operational Efficiency and Permit Electronic Document Exchange Between Medicaid Providers and the Office of Program Integrity
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OAR 410-120-1990, Repeal 410-130-0610 Establishes New Overarching Telehealth Rule Authorizing Medicaid Coverage of Fee-for-Service Health Service Benefits
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Division 123 - Dental Program Rules Update
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Division 141 - Semi-Annual CCO Rule Updates & Telehealth Service and Reimbursement Requirements
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Division 170 - Updates Behavior Rehabilitation Services Rules for Accuracy and Aligns Rule with SB 171 and Family First Act
Reminder: Medicaid EHR Incentive Program is now open
OHA is now accepting Program Year 2020 attestations until March 31, 2021. Program Year 2019 participants must have their 2019 attestation fully processed and paid before submitting an attestation to Program Year 2020.
For questions related to the Medicaid EHR Incentive Program (aka Promoting Interoperability Program), please contact OHA at 503-945-5898 or email Medicaid.EHRIncentives@dhsoha.state.or.us.
Reminder: Use MSC 189 form to request Electronic Fund Transfer (EFT) account updates
Until further notice, please use the MSC 189 (EFT Enrollment Form for Providers, Vendors, and Contractors) to update your EFT account information.
OHA has deactivated the EFT Account update feature in the Demographic Maintenance panel of the MMIS Provider Portal in order to determine additional security features needed for EFT updates in the Portal.
This week, Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) announced proposed changes to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to support individuals’ engagement in their care, remove barriers to coordinated care, and reduce regulatory burdens on the health care industry. The proposed changes include:
- Strengthening individuals’ rights to access their own health information, including electronic information;
- Improving information sharing for care coordination and case management for individuals;
- Facilitating greater family and caregiver involvement in the care of individuals experiencing emergencies or health crises;
- Enhancing flexibilities for disclosures in emergency or threatening circumstances, such as the Opioid and COVID-19 public health emergencies; and
- Reducing administrative burdens on HIPAA-covered health care providers and health plans, while continuing to protect individuals’ health information privacy interests.
OCR encourages comments from all stakeholders, including patients and their families, HIPAA-covered entities (health plans, health care clearinghouses, and most health care providers) and their business associates, consumer advocates, health care professional associations, health information management professionals, health information technology vendors, and government entities.
Public comments on the Notice of Proposed Rulemaking will be due 60 days after the Notice’s publication in the Federal Register.
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