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
Administrative add-on fee for interpreter services extended for duration of the COVID-19 public health emergency: The Oregon Health Authority (OHA) will continue to pay an administrative add-on fee for interpreter services at fee-for-service health care visits for the duration of the COVID-19 public health emergency. The administrative add-on rate is $60 per date of service.
This fee supports the costs providers incur for ensuring patient access to interpreters as required by federal and state law for limited English proficient, non-English proficient, and Deaf or hard of hearing members.
To learn more about this change and review OHA's December 2020 memo about the fee, please read the announcement from OHA.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to OHP and CAWEM coverage of vaccine, testing, screening, treatment and telemedicine services; OHP and CAWEM eligibility; and other information and resources related to providing and billing for covered services during COVID-19.
- The guide has been updated to reflect OHA coverage of the interpreter services add-on fee for the duration of the COVID-19 public health emergency.
Updates for all health care providers
Emergency Broadband program provides discounted internet service during the pandemic
Many Oregonians are struggling to access telehealth and other virtual services because they can't afford internet. During the pandemic, many Oregonians can now get a monthly discount on internet service from the new federal Emergency Broadband program. Households may qualify if at least one household member:
- Qualifies for, or already receives, Lifeline program benefits;
- Receives benefits under the free and reduced-price school lunch program or the school breakfast program;
- Received a federal Pell Grant during the current award year;
- Experienced a substantial loss of income since Feb. 29, 2020 (if the household income is under a certain threshold); or
- Meets the eligibility criteria for a participating internet service provider's existing low-income or COVID-19 program.
There are three ways for eligible households to apply:
-
Contact a participating broadband (internet) provider directly to learn about their application process.
-
Go to GetEmergencyBroadband.org to apply online and to find participating providers.
-
Call 833-511-0311 for a mail-in application, and return it with copies of documents showing proof of eligibility to:
Emergency Broadband Support Center P.O. Box 7081 London, KY 40742
For resources you can share with patients, view the FAQ and Consumer Toolkit on the program's website.
Value-based payment (VBP) webinar series for providers (no-cost CME available): Next webinar is June 2
Primary care, behavioral health, and maternity care providers are invited learn about increasing readiness for VBP and taking advantage of the additional flexibility VBPs offer for innovatively redesigning care models. Remaining sessions are noon to 1 p.m.
-
June 2: VBP for behavioral health providers: How do we keep from being left out?
-
June 16: VBP and maternity care: What have we learned so far?
Speakers: Art Jones, Jeanene Smith, Janet Meyer (Health Management Associates)
Questions? Email OHA.VBP@dhsoha.state.or.us.
Diabetes metrics toolkit webinar: June 22, noon to 1 p.m.
At this hour-long live webinar, Oregon Rural Practice-based Research Network facilitators will walk through how to use the new diabetes metric toolkit in primary care and dental clinical settings and answer your questions.
This new toolkit will be available to everyone and has many real-life example improvement projects, templates and inspiration to:
- Conceptualize, design and implement your own quality improvement projects.
- Apply quality improvement frameworks and tools for measurable change in diabetes, HbA1c poor control and oral health evaluation for adults with diabetes.
The webinar will be recorded, and the recording will be available after the webinar.
Questions? Email Laura Ferrara at ORPRN_TA@ohsu.edu.
Administrative Examination program updates
Reprocessing of incorrectly denied April 2021 claims: OHA recently found and corrected a system error that incorrectly denied some administrative examination claims processed from 4/1/2021 through 4/27/2021. Please accept our apology for any inconvenience this may have caused. OHA is now working to reprocess and resolve these claims.
Email OHP 729 authorizations to OHA for faster processing of related claims: The authorizing agency is required to submit the OHA 729 form authorizing the services you bill to OHA; however, if we do not receive the form by the time you bill OHA, our system will suspend the claim for 10 days. If OHA does not receive the form within 10 days of billing, our system will deny the claim.
- To avoid processing delays, please send your copy of the OHP 729 form via secure email to OHA.ffsohpclaims@dhsoha.state.or.us.
- We are currently revising the OHP 729 form so that a copy will automatically be submitted to OHA upon completion by the authorizing agency. When this revision is complete, we will let you know, so that you are aware that it is no longer necessary to submit this form to us.
Reimbursement for S9981 (Medical records copying fee, administrative): This code is only allowable and reimbursable through the Administrative Examination program and requires an OHA 729 form. If you need to bill for copying fees but did not receive a completed OHA 729 form that includes this code, please contact the requesting agency for this form and send it via secure email to OHA.ffsohpclaims@dhsoha.state.or.us.
Administrative Exam fee schedule updates: For updates and code limitations, please review the most current fee schedule located on the Administrative Exam Policy Page. The updated fee schedule reflects several updates and limitations on coding provided by the Centers for Medicare & Medicaid Services.
Recent rule revisions
OAR 410-140-0160 - Updating Rule for Coverage of Corneoscleral Lenses to Support Practice and Needed Member Services
OAR 410-200-0120 - Updating OAR Language to Align with Updated Federal Guidance Regarding the Non-citizen Eligibility Policy
OAR 410-130-0245 - Removes Rule Language Regarding Blood Lead Screening That Is Inaccurate and Conflicts with Other Rule
|