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.
Join the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) for its next webinar on May 9, 2023, from 10 to 11 a.m. Pacific Time
Community partners, coordinated care organizations, providers, insurers, and more are invited to register for the next in a series of monthly opportunities to learn more about how OHA and ODHS are working together to prepare benefit recipients for potential changes in their Oregon Health Plan (OHP) and other benefits, including long-term services and supports and food benefits as the federal COVID-19 Public Health Emergency (PHE) phases out.
Agenda:
- COVID-19 PHE unwinding timeline and updates
- Basic Health Plan overview
- Medical renewal updates
- Food benefit updates
- New resources for partners
Language and disability access: American Sign Language and live closed captioning will be available for this meeting. A separate Spanish webinar will be held May 18, 2023, at 10 a.m. Pacific Time.
Everyone has a right to know about and use ODHS and OHA programs and services. ODHS and OHA provide free help. For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Feedback team at 503-945-5488 or feedback@odhsoha.oregon.gov at least 2 business days in advance of the webinar. ODHS and OHA accept all relay calls.
New English and Spanish videos about OHP renewal letters
OHA has created these short video messages instructing people how to update their address, and reminding people to keep watching their mail and to do what their renewal letter asks.
Watch the video in English or Spanish.
Feel free to share these to help spread the word!
The videos are also available on the Renew Your OHP page.
Notices Guides now available
Notices Guides outline the general sections and content of different types of Oregon Eligibility (ONE) notices OHP members may receive during the renewal process. These guides can be used to help people understand what to expect and how to navigate the medical renewal process. The guides are in English and Spanish for these notices:
- Combined Request for Information
- Medical Active Renewal Notice
- Medical Notice of Eligibility
- Medical Passive Renewal Notice of Eligibility
- Medical Passive Renewal Request for Information
- Notice of Reminder for Renewal and Request for Information
Fee-for-service reprocessing of inpatient claims planned for the week of May 15, 2023
The week of May 15, 2023, the Oregon Health Authority (OHA) plans to reprocess all inpatient claims paid between October 1, 2022 and January 29, 2023.
Why is this happening?
January 29, 2023, OHA updated its claims system with Version 40 of the Medicare Severity Diagnosis Related Group (MS-DRG) grouper software. The May 15, 2023 reprocessing will ensure that the claims listed above comply with this update.
Payment Error Measurement Rate Program (PERM) and requests for medical records
Later this month, PERM will start sending letters to approximately 565 Oregon health care providers. The letters will ask for medical records for a random sample of Medicaid/CHIP claims.
If you receive a medical records request from PERM, please follow the instructions in the letter.
Visit the PERM website to learn more:
- View their webinar for providers
- View a sample medical records request
- Read frequently asked questions (FAQ) for providers
- View PERM claim categories
Recent rule revisions
OAR 410-121-0040: Amending Prior Authorization Approval Criteria Guide
Provider updates
Provider resources
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