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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
Update to fee-for-service coverage of COVID-19 home testing: Effective Dec. 1, 2021, the Oregon Health Authority (OHA) has expanded coverage of FDA-authorized over-the-counter COVID-19 home testing kits for Oregon Health Plan and CAWEM members.
- For kits that require an internet connection or a smartphone for test interpretation, OHA will now cover up to four tests per month without a primary care provider's (PCP) order or prior authorization.
- OHA may cover more than four units per month when ordered by the PCP as a necessary component of an individualized care plan.
To learn more, please read OHA's provider announcement and fax to Oregon pharmacies.
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 now includes the following information:
- Coverage of COVID-19 home tests that require an internet connection or smartphone for test interpretation
 Virtual learning sessions: Pediatric COVID vaccines for clinics
The OHA Transformation Center, in partnership with the OHA Vaccine Planning Unit, is hosting a learning series focused on pediatric COVID-19 immunizations.
As a participant, you will hear from subject matter experts and peers on key topics such as pediatric vaccine updates, how to build vaccine confidence in parents, and using equity in all planning and delivery of vaccine. Time will be reserved to answer questions from clinical staff.
Space will be limited to the first 500 participants. Please register for each date below and join us via Zoom. All sessions are Thursdays from noon to 1 p.m. Pacific Time.
 Updates for all health care providers
OHA’s value-based payment (VBP) website now features a library of resources that covers a wide range VBP topics, including:
- Overviews
- Risk stratification
- Attribution
- Evidence-based care and workflows
- Performance measurement
- Promoting health equity
- Emerging trends
In addition, you’ll find pages with VBP resources for each of the five care delivery areas required in CCO contract:
- Hospital
- Maternity
- Behavioral health
- Oral health
- Children’s health
OHP 1115 Waiver Renewal policy concepts now published
OHA is pleased to announce the publication of the final policy concept papers that outline changes OHA proposes to make to the Oregon Health Plan (OHP) as part of our effort to advance health equity.
- These concepts are the basis of OHA’s upcoming application to the Centers for Medicare & Medicaid Services (CMS).
- If approved, Oregon would make these changes to OHP during the 2022 – 2027 demonstration period.
OHA has also produced plain language summaries of the policy concepts, which you will find linked alongside the policy papers. All documents are available in 12 languages on OHA’s 1115 Demonstration Waiver renewal web page.
Next steps:
OHA is currently drafting its application to CMS and working with our Tribal partners to ensure alignment with Tribal priorities. The draft application will be posted on the OHA website for public comment in December.
In the meantime, OHA welcomes feedback on the policy concepts. You can send feedback via:
To receive future OHP 1115 waiver updates:
Sign up for OHP 1115 Demonstration Waiver updates from OHA.
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