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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
On May 24, 2022, the Health Evidence Review Commission (HERC) updated the Novel Coronavirus Coding guide.
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.
Provider Collaborative: 2022 Citizenship Waived Medical (CWM) program changes
As of Jan. 1, 2022, the CWM benefit plan now includes outpatient dialysis, cancer and behavioral health crisis treatment. More policy and system changes are coming soon.
The Oregon Health Authority (OHA) invites Medicaid providers and community partners to join the Community Partner Outreach Program and other teams at OHA for a conversation about these changes.
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Date and time: June 17, 2022, 10 a.m. to noon
After registering, you will receive a confirmation email containing information about joining the webinar.
 Payment Error Rate Measurement (PERM) overview webinar
The PERM Provider Education webinar is intended to explain the PERM program and help Medicaid and CHIP program providers to better understand:
- The PERM program.
- The PERM medical review process.
- PERM medical record and documentation requests.
- Methods for record submission.
- Provider best practices.
- PERM resources for providers.
This recorded webinar is an opportunity for providers to better understand their responsibilities during a PERM cycle.
About PERM:
The PERM program is designed to measure and report improper payments in the Medicaid and CHIP programs. The improper payment rate is not a “fraud rate” but a measurement of payments made that did not meet statutory, regulatory, or administrative requirements. These improper payments may be overpayments or underpayments and do not necessarily represent expenses that should not have occurred.
The PERM program measures each state once every three years. To learn more, visit the PERM website.
PANDA/PANS coverage guidance approved May 19, 2022
On May 19, 2022, HERC approved a new coverage guidance for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute Onset Neuropsychiatric Syndrome (PANS).
The changes will take effect in the Jan. 1, 2023 Prioritized List of Health Services.
Questions? Please email HERC.Info@dhsoha.state.or.us.
 Provider resource updates
OHA has updated the Institutional Billing Instructions to add that the attending physician must be enrolled with OHA.
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