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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
No updates at this time.
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.
 Updates for all health care providers
Health Evidence Review Commission seeks part-time Medical Director
The Health Evidence Review Commission is now recruiting for a part-time Medical Director position (around 0.25 FTE, subject to negotiation). This position would be responsible for making evidence-based recommendations regarding coverage and prioritization of health services for the Commission to use in maintaining the Prioritized List of Health Services and in developing evidence-based reports. The Prioritized List governs coverage for over 1 million Oregonians on the Oregon Health Plan.
In order to make these recommendations, the Medical Director must:
- Conduct literature reviews, synthesize the available evidence, consult with experts, consider the equity impact of current policy and any proposed changes and write concise summaries to present to the Commission in public meetings.
- Consult with other Oregon Health Authority (OHA) staff on topics such as appeals of coverage denials and implementation of benefits.
- Provide clinical expertise from an evidence-based perspective.
- Represent OHA and the Commission to provider groups as well as other organizations and the public.
- Serve as a liaison between the medical community and OHA on a variety of topics.
 OHA seeks new members for Pharmacy and Therapeutics Committee and Mental Health Clinical Advisory Group
OHA seeks new members for both the Pharmacy and Therapeutics Committee (P&T Committee) and Mental Health Clinical Advisory Group (MHCAG). Both are crucial to OHA’s strategic goal to eliminate health inequity by 2030, as well as the agency’s mission, vision and values. Presently, OHA is seeking applications from:
- Actively practicing physicians for the P&T Committee
- Actively practicing community psychiatrists (pediatric or adult) for the MHCAG
- Licensed clinical psychologists (2) for the MHCAG
- An individual representing a coordinated care organization (CCO) for the MHCAG
Recent rule revisions
OAR 410-120-1210 - Outpatient Dialysis, Behavioral Health Crisis, And Chemotherapy To Be Added To CAWEM Benefit Package
OAR 410-121-0030, 410-121-0040 - Amending Prior Authorization Approval Criteria Guide And Preferred Drug List DUR/P&T Actions
OAR 410-130-0605 - Establishes Newborn Nurse Home Visiting Medical Services
OAR 410-138-0000, 410-138-0005, 410-138-0020, 410-138-0040, 410-138-0060 - Establishes Newborn Nurse Home Visiting TCM Services
OAR 410-141-3855 - Clarifying Requirements for CCO Contracted Providers to Check the Prescription Drug Monitoring Program Database before Prescribing Controlled Substances
OAR 410-172-0650, 410-172-0695 - Medicaid Intensive In-home Behavioral Health Treatment (IIBHT) Rule Alignment with IIBHT Behavioral Health Programming Rules
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