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
Behavioral health personal care attendant (PCA) reimbursement for trips to COVID-19 vaccination appointments: The Oregon Health Authority (OHA) will pay qualified and enrolled PCAs for mileage and time spent to transport individuals eligible for behavioral health PCA services to COVID-19 vaccination appointments. PCAs may be reimbursed for these costs for dates of service on and after Dec. 14, 2020, for the duration of the COVID-19 public health emergency. This authorization covers the following:
- Mileage to and from the COVID-19 vaccination appointment in the PCA’s own vehicle, using the most direct and reasonable route from the individual’s home to the vaccination site.
- Time accompanying the individual at the vaccination appointment, if this service is not already included in the current service plan, or was not already claimed as part of the allotted time on their voucher for the pay period that the COVID-19 vaccination occurred.
Prior authorization through local case management or Comagine Health is not required. To learn how to request reimbursement, please read the June 3 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 with information about PCA reimbursement for trips to COVID-19 vaccination appointments.
June 16 webinar, noon to 1 p.m. "Value-based payment and maternity care: What have we learned so far?"
While Medicaid eligibility rules vary by state, coverage for maternity care is mandated for all Medicaid members. There is significant disparity in birth outcomes among racial groups due to many factors, including social determinants of health. This has prompted the development of new clinical approaches to prenatal, post-partum and neonatal care.
This session will review experience to date with those models of care and value-based payment (VBP) reform efforts to support them. We will look at VBP approaches that have been implemented in Oregon and nationally, their outcomes and challenges. We will discuss how applying the lessons learned could inform potential approaches to value-based payment for maternity care in Oregon.
After this webinar, participants will be able to:
- Name the key 2-3 lessons learned from maternity care VBP from Oregon and other states’ efforts to date.
- Describe the major challenges with maternity care VBP.
- Name 1-2 potential approaches for maternity care VBP in Oregon.
State and federal requirements for offering language access services
Providers must ensure all services, including telehealth/telemedicine services, preserve meaningful access to language services as required by Title VI of the Civil Rights Act, the Americans with Disabilities Act (ADA), Section 1557 of the Affordable Care Act and corresponding regulations at 45 CFR Part 92 (Section 1557). This includes but is not limited to:
- American Sign Language (ASL) interpretation services to individuals who are Deaf or Hard of Hearing and
- Spoken language interpretation services for individuals with limited English proficiency (LEP).
Interpreter services must be free, timely and protect the privacy and independence of the LEP individual. The interpreter must be a certified or qualified health care interpreter. This can be:
All providers who accept Medicaid or Medicare must provide interpretation services. Family members or friends cannot be asked to provide interpretation.
Providers may suffer serious penalties for not meeting these requirements.
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OAR 410-120-1380(1)(c)(A)(3) requires all providers and subcontractors to ensure compliance with ADA requirements when providing health care services to OHP members.
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OAR 943-005-0060(1)(c) requires all OHA contractors and subcontractors to establish nondiscrimination and reasonable modifications policies. Section 5 of this rule also requires timely and meaningful notification to individuals about these policies.
To learn more and find resources to help providers meet federal language access requirements, visit the Office of Civil Rights website.
Reminder: Bill OHA for interpreter services arranged for fee-for-service health care visits
OHA now offers a $60 add-on fee to support the cost of arranging interpreter services at fee-for-service health care visits covered by the Oregon Health Plan.
- This fee became effective Jan. 1, 2021, and OHA is seeking federal approval to make the fee permanent.
- Providers can bill OHA for this fee as an added detail line when billing for the covered health care visit.
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