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. The guide:
- Now contains links to previously issued memos in the "Previous Guidance" sections for COVID-19 services (page 19) and medical transportation (page 37).
- Is updated with additional COVID-19 vaccine administration codes (pages 8 and 45).
- No longer contains information about HRSA's provider reimbursement program for COVID-19 services provided to uninsured individuals. This program stopped accepting claims for testing and treatment on March 31, 2022. It stopped accepting claims for COVID-19 vaccine administration on April 5, 2022.
Doing Well, Being Well Series: Breathwork for Wellness
Lines for Life offers this free, interactive webinar series as part of the Oregon Helpers Wellness Initiative to support provider resiliency and well-being during COVID-19.
May 26 at 9 a.m. Pacific Time, join Aaron Overstreet, a leader in the breathwork community, to explore breathwork and its connection to wellbeing.
- How can professional helpers better serve our clients and patients through understanding the breath and its connection to healing trauma and distress?
- How can we also use this understanding to assist with the self-care required to be effective helpers?
This webinar answers these two questions and offers insight into the use of “breathwork” or “conscious breathing” to achieve different goals. We can help others to simply relax with breathwork, or we can use it to help others process trauma and past painful experiences that hold them back. Awareness of the breath and how it speaks to us can be a useful tool in the helping professions.
Registration will remain open until the morning of the event.
Resource updates:
Eating disorders frequently develop during childhood, adolescence and during the transition from adolescence to adulthood. Children and youth benefit from screening for eating disorders for early detection and to identify those at risk of developing these disorders. The earlier an eating disorder and associated behaviors are recognized, diagnosed, and effectively treated, the better the long-term outcomes.
Effective eating disorder treatment:
- Is delivered by a multidisciplinary team composed of behavioral health/mental health providers, nutrition therapy providers and medical providers.
- Stabilizes the individual's medical and nutritional needs while providing mental health therapies.
- Encourages use of family and youth peer support services when appropriate in the treatment cycle.
The Oregon Health Authority (OHA) is pleased to provide this training, funded by Mental Health Block Grant dollars, to:
- Impart essential knowledge about eating disorders and
- Increase the number of behavioral health providers skilled in identifying and addressing eating disorders.
Dates and times
These monthly virtual training sessions begin June 8 and end December 7. Held once a month from noon to 1:15 p.m., the sessions include 1 hour of instruction and a 15-minute question and answer session.
Unless otherwise noted, each session is eligible for 1 Continuing Education Unit (CEU) through the National Association of Social Workers (NASW). Registration is required to earn CEUs for each session.
Questions?
If you have questions about this learning opportunity, please email Kathleen Burns.
CWM coverage of emergency cancer and behavioral health crisis treatment, effective Jan. 1, 2022
As of Jan. 1, 2022, the Citizenship Waived Medical (CWM) benefit plan covers emergency cancer and behavioral health crisis treatment. OHA expects to update the Medicaid Management Information System (MMIS) with the covered diagnosis codes by late June.
When this work is complete, we will let you know and update the list of CWM emergency diagnosis codes. In the meantime:
- Please wait to bill OHA for these services until the codes are added to MMIS as covered CWM emergency codes.
- If you choose to bill for these services earlier, OHA will deny the claims, then reprocess them in July.
- Use procedure codes 90839 and/or 90840 to bill for behavioral health crisis treatment.
Questions? Please call Provider Services at 1-800-336-6016. Members can contact Client Services at 1-800-273-0557.
Fee-for-service rate increase for neonatal and pediatric intensive care professional services
OHA is adopting an Oregon-specific rate conversion factor for procedure codes associated with pediatric or neonatal intensive care provided on or after Jan. 1, 2022.
- The Oregon-specific rate conversion factor will allow OHA to increase rates for procedure codes 99468 – 99480.
- OHA is currently making updates to MMIS to process claims using the new rate conversion factor. Once updates are complete, we will let you know.
In the meantime:
- Please do not bill for procedures 99468 – 99480 until OHA completes updates to MMIS for this rate change.
- For 2022 claims already submitted for these procedures, we will provide guidance on any actions needed for you to apply the rate increase to those claims.
Increased fee-for-service dispensing fee for monofocal glasses, effective July 1, 2022
Once prescribed glasses, Oregon Health Plan members must often search for a provider who will fit and dispense them, sometimes across several counties. To address this access issue, OHA has increased the fee-for-service fitting fee for monofocal glasses to $130.00.
We hope this increase will encourage participating vision service providers to order and then fit the appropriate glasses through SWEEP Optical, the only optical provider covered by OHA's fee-for-service program.
Delegated nursing in OHA-licensed residential settings
OHA has created this document for providers performing delegated nursing tasks in residential settings. It includes:
- How delegated nursing tasks are addressed in a resident's Plan of Care
- How to document delegation of nursing tasks
- Steps to take before delegating a nursing task to a staff member
- How to ensure the resident's choice of staff who provide 1915(i) services
To find other resources for residential providers, please visit the OHP Behavioral Health Policy page.
Change log for Jan. 1, 2022 Prioritized List of Health Services
The Health Evidence Review Commission has posted a Change Log and associated placement files for the 1/1/2022 Prioritized List of Health Services.
Questions? Please email HERC.Info@dhsoha.state.or.us.
Join OHA's monthly Administrative Exams Collaborative starting June 7, 2022
OHA invites providers who fulfill administrative exam and report requests from Oregon Department of Human Services, Oregon Youth Authority and OHA programs to join this monthly online collaborative. The collaborative will act as a forum to discuss, educate, and work with providers to continuously improve the system.
OHA will hold collaborative meetings the first Tuesday of each month at 1 p.m.
To join this group, please email Shannon Jasper.
|