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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
None at this time.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to Oregon Health Plan (OHP) and Citizenship Waived Medical (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.
Other COVID-19 updates
Interim Investigative Guidelines (10/20/2022)
New partner toolkit to support people receiving benefits
Oregon Department of Human Services (ODHS) and the Oregon Health Authority (OHA) have prepared a toolkit to support partners as they help people receiving OHP, long-term services and supports or SNAP food benefits prepare for possible changes when the federal COVID-19 emergency ends. The toolkit:
- Is available in Arabic, Simplified Chinese, Traditional Chinese, Chuukese, English, Hmong, Korean, Marshallese, Portuguese, Russian, Somali, Spanish and Vietnamese.
- Contains resources to download and use in your offices, such as talking points, email and newsletter copy, social media posts, flyers, and more.
ODHS and OHA strongly encourage you and your partners to download, use and share these resources in your community. They are available anytime at Oregon.gov/COVID-PHE-Partners.
Be sure to join our Nov. 15 partner webinar:
Each webinar offers time for you to ask questions you may have about preparing for the end of the federal COVID-19 Public Health Emergency.
Scam alert: Fake caller posing as OHA asking for personal health information
The ODHS|OHA Information Security and Privacy Office (ISPO) is alerting clients, partners and staff to stay vigilant when receiving phone calls.
Recently, an OHA employee reported receiving a call from a scammer posing as OHA under the name “OHA Choice.” The caller claimed they were performing a survey on personal health. OHA is not administering any surveys under the name OHA Choice.
Typically, these types of scams, whether by phone, text, or email are intended to obtain your personal information such as medical record information, social security number, credit card bank information and more.
How to protect yourself
- Never give personal information to anyone over the phone that you do not legitimately know.
- Consider blocking the number.
- Do not respond to any survey text messages and delete immediately.
What to do if you receive or suspect a scam call
Visit the Oregon Department of Justice online at www.oregonconsumer.gov or call 1-877-877-9392
Questions?
Contact ISPO at 503-945-5780 or dhs.privacyhelp@odhsoha.oregon.gov.
Medicaid coverage of outpatient gambling disorder treatment services
OHA is working to add outpatient gambling disorder treatment services to OHP (Medicaid) benefits starting Jan. 1, 2023. OHA hopes this expansion will add new service providers to Oregon's gambling disorder treatment system.
OHA has developed a Frequently Asked Questions (FAQ) document to answer questions from provider organizations and coordinated care organizations (CCOs). Read the FAQ to learn about:
- OHA's requirements for becoming a Medicaid-eligible gambling disorder treatment provider
- Recommended training for staff pursuing required certification
- Other resources available to support program development and training
Questions? Please contact the OHA Problem Gambling Services Manager, Greta Coe, at greta.l.coe@dhsoha.state.or.us.
Language access requirements for health care providers
Health care providers must provide the following at no cost to Medicaid members:
- A qualified or certified health care language interpreter to members with Limited English Proficiency (LEP), and
- Communication services for people who are deaf and hard of hearing.
To achieve OHA's goal of eliminating health inequities by 2020, we must ensure meaningful access to services throughout our health care system.
Oregon Administrative Rule 410-120-0001 requires OHP providers to provide these services. Many other state and federal laws also require health care providers to provide meaningful access to care.
CWM coverage of immunosuppressant medications post-kidney tranasplant
OHP covers immunosuppressant medications post-kidney transplant for CWM members, effective Jan. 1, 2022.
- Prescriptions for these medications require prior authorization.
- To help CWM members access prescriptions for this medication, OHA's fee-for-service OHP Care Coordination program will refer CWM members to a nephrologist for ongoing appointments and labs.
OHA expects to be able to process fee-for-service claims for these appointments and labs in December. If you provide these services to CWM members, please hold claims until December, or bill using a paper claim.
Other Medicaid program updates
Provider resource updates
Pharmaceutical Services Provider Guide (11/2/2022)
Novel Coronavirus Coding (11/2/2022)
Corrected Oct .1, 2022 Hospice Program Rates (11/3/2022)
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