|
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
None at this time.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to OHP and CWM coverage of vaccine, testing, screening, treatment and telemedicine services; OHP and CWM eligibility; and other information and resources related to providing and billing for covered services during COVID-19.
Formula shortages continue to be a challenge across the state due to the Abbott recall and supply chain shortages. If you work with WIC families, here are tools to assist you and your staff:
Attend OHA's no-cost virtual trainings (with CME), June 2022 through February 2023
Oregon Medicaid providers are invited to learn more about motivational interviewing for diabetes management. Led by Dana Sturtevant, MS, RD, the trainings will focus on improving providers' confidence and skills in conversations about sensitive behavior change topics required for diabetes management.
Three types of trainings are available. You will have multiple opportunities to attend each training between June 2022 and February 2023:
- Motivational interviewing for diabetes management: Level 1
- Motivational interviewing for diabetes management: Level 2
- Using motivational interviewing in diabetes management groups
The Value-based Benefits Subcommittee of the Health Evidence Review Commission (HERC) has a current vacancy and is accepting applications from naturopathic physicians through May 31, 2022 or until this volunteer position is filled.
About the subcommittee:
The subcommittee makes recommendations to HERC on coverage policy related to health conditions and services.
- Subcommittee members discuss available clinical evidence, provider expertise, patient concerns and costs and generally take a deeper dive of the issues that are later presented to the HERC.
- The subcommittee's recommendations are referred to the HERC for final decisions.
If you have questions about this vacancy:
Please email herc.info@dhsoha.state.or.us.
Process change for calls to the Prior Authorization and Code Pairing Hotlines
Starting Monday, May 9, you will need to provide your National Provider Identifier and/or your patient's Oregon Medicaid ID when you call the Prior Authorization Hotline at 800-336-6016 (option 3), and Code Pairing Hotline at 800-336-6016 (option 4).
- This will allow OHA to better document and track provider phone calls.
- Please be prepared to provide this information each time you call.
OHA will log your call with a reference number to document your issue. If you need to make follow-up calls about this issue, you can provide OHA the reference number to track the progress of your issue.
Changes to fee-for-service provider revalidations
State Medicaid agencies must revalidate enrolled providers at least every five years. This review ensures that each provider:
- Has current information on file, and
- Still meets federal Medicaid requirements for provider participation.
Starting this month, OHA has made the following changes to the revalidation process:
- OHA will initiate revalidations by provider type instead of effective date.
- OHA now posts a weekly Revalidation File that lists the providers currently under revalidation, and shows the status of each provider.
OHA hopes these changes will:
- Improve the return rate of applications, reducing provider inactivations.
- Increase the transparency of the process.
If you have questions about revalidation:
Please email Provider.Revalidation@dhsoha.state.or.us.
 Provider resource updates
Frequently asked questions: Delegated nursing tasks in OHA-licensed residential settings (5/3/2022)
Oregon Medicaid Pharmaceutical Services PA Criteria (5/1/2022)
Behavioral Health Fee Schedule Fact Sheet (4/28/2022)
Substance use disorder treatment codes and rates effective January 1, 2022 (4/28/2022)
 Recent rule revisions
OAR 410-121-0040: Amending Prior Authorization Approval Criteria Guide Effective May 1, 2022
OAR 410-141-3830: Clarification of Prioritized List Guideline Notes in Rule
OAR 410-180-0305, 410-180-0315, 410-180-0320, 410-180-0325, 410-180-0326, 410-180-0340, 410-180-0350, 410-180-0370, 410-180-0375: Amend Traditional Health Workers Rules to Make Necessary Changes for Compliance with CMS Medicaid Requirements
|
