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.
OHP Renewal Experience Timeline now available
The new Renewals Experience Timeline is an interactive tool outlining the key dates, activities, processes and worker impacts that will happen when OHP renewals begin in April and continue into mid-2024.
The goal of this tool is to provide the same situational awareness for both staff and partners, so everyone is on the same page with these processes. This tool is a resource to work with OHP members “where they are” by providing a deeper understanding of the medical renewals process.
There are specific member scenarios and key milestones for each renewal period so partners can help members understand how to continue their benefits.
Join the Oregon Department of Human Services (ODHS) and Oregon Health Authority (OHA)'s monthly partner webinar series
What to expect:
- Information on how Oregon is preparing for benefit changes
- Communication tools partners can use to engage people who receive benefits
- Time for questions and feedback
The webinars are hosted in English and Spanish. Webinars are from 10 to 11 a.m. Pacific Time.
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English webinars: March 14, April 11, May 8
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Spanish webinars: March 23, April 23, May 18
Recordings and materials from past webinars are available at oregon.gov/covid-phe-partners.
American Sign Language and live closed captioning will be available. Email Jon McDaid at at least 48 hours before each webinar if you need help or have questions.
New Marketplace transition webinar
The Oregon Health Insurance Marketplace is hosting webinars to discuss transitions from OHP to Marketplace coverage during the COVID-19 Public Health Emergency unwinding process.
Webinar topics will include:
- Notices individuals should expect to receive
- Unwinding special enrollment period (SEP) details
- Transitioning during open enrollment
English webinar: Wednesday, March 22 from 10 to 11 a.m., Pacific Time.
Spanish webinar: Wednesday, March 29 from 10 to 11 a.m., Pacific Time.
OHIM welcomes all participants. If you have any questions about accommodations or need any assistance to participate please call or email: Amy Coven at amy.coven2@oha.oregon.gov or 503-943-0164 (voice/text). All relay calls are accepted.
Sign up for OHA's new partner newsletter: Keep Covered
The Keep Covered newsletter shares the latest information about changes coming for people with OHP and other benefits, including services and supports for people with disabilities and older adults, and food benefits.
Member and community survey to help shape 2024 Network Adequacy rules
The Network Adequacy Project Team in Health Systems Division has launched a survey to gather feedback about proposed changes to Network Adequacy rules (Oregon Administration Rule 410-141-3515). Everyone is welcome to provide feedback.
The survey deadline is April 3, 2023.
The team also created some educational tools to help explain the importance of network adequacy and what the proposed changes mean, including a video and new "Time and Distance" web pages.
Please help us spread the word and share these resources with anyone who may be interested.
Fee-for-service reprocessing for certain Home and Community-Based Services (HCBS) claims starting March 3, 2023
Starting this month, OHA is reprocessing certain HCBS claims with paid dates from April 1, 2021, through March 31. 2022, so that OHA can receive increased federal match for these claims as authorized in the American Rescue Plan.
- For claims where this activity causes OHA to pay less than the original paid amount, OHA is paying the difference between the original and reprocessed claims.
- For School-Based Health Services and Targeted Case Management claims, this activity will cause OHA to return money to their local match account.
Provider resources
Culturally and Linguistically Specific Services (CLSS) Billing Guide (3/7/2023)
Citizenship Waived Medical (CWM) and CWM Plus fact sheets now available in multiple languages on the CWM Policy page.
March 2023 Behavioral Health Fee Schedule
March 2023 Medical/Dental Fee Schedule Addendum - This contains codes not listed in the December 2022 Medical/Dental Fee Schedule
Other updates
Oregon Health Plan Handbook for January 2023 now available in these languages:
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