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
Face-to-face and in-person assessments required for individuals who receive 1915(i) and Behavioral Health Personal Care Attendant (BH PCA) services effective Aug. 15, 2023: Starting Aug. 15, 2023, Comagine Health will no longer perform service eligibility assessments by phone. Instead, Comagine Health must complete all assessments:
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In person or via telehealth for 1915(i) services, as described in Oregon Administrative Rules (OARs) 410-172-0850 and 410-120-1990.
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In person for BH PCA services, as described in OAR 410-172-0830(2).
If consumers need an assessment of their 1915(i) or BH PCA service eligibility on or after August 15, please let them know that their assessment will be through telehealth or in-person for 1915(i) and in-person for BH PCA.
 Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to Oregon Health Plan (OHP) coverage of COVID-19 vaccine, testing, screening, treatment and telemedicine services and other information and resources related to providing and billing for covered services during COVID-19.
Review what is ending and continuing with the May 2023 end of the COVID-19 Public Health Emergency (PHE): View the May 2023 memo from Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS).
Winding down the COVID-19 Public Health Emergency
Join ODHS and OHA for webinars about how the two agencies are working together to wind down the COVID-19 Public Health Emergency.
Webinars are held in English and Spanish from 10 to 11 a.m. Pacific Time.
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English webinars: September 12 and November 14.
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Spanish webinars: September 21 and November 16.
OHP covers organ transplants for members eligible through Healthier Oregon
The following Oregon Administrative Rules (OARs) explain that OHP members who became eligible through Healthier Oregon qualify for state-funded organ transplants:
OHA will update OAR 410-124-0040(3) to clarify that organ transplants are covered as a state-funded service for members who qualify for OHP through Healthier Oregon.
Some eligible CWM members have not yet moved to full OHP benefits
July 1, 2023, close to 40,000 Citizenship Waived Medical (CWM) and CWM Plus members moved to full OHP benefits through Healthier Oregon. However, approximately 1,600 members did not.
If you serve a CWM member who does not have full OHP benefits yet:
Thank you very much for your help.
 We want your input on rules for OHP coverage for members under 21!
The Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT) ensures complete health care coverage for OHP members under age 21. Starting in 2023, more things can now be covered for members under 21 because of EPSDT.
OHA is updating the administrative rules for EPSDT. This will help make sure the new requirements about coverage are clear. OHA, CCOs and OHP providers must follow these rules when deciding about coverage for OHP members under age 21.
We would love to have your input! We want these rules to reflect the needs of OHP members under 21 and their families, as well as the providers and CCOs who serve them. We are looking for OHP members, parents/caregivers, providers, navigators/assisters, CCO staff and others to help us with this. You can choose to:
- Participate in a Rules Advisory Committee (RAC) meeting on August 8 or 9. At RACs, community members provide input and suggestions about updating the rules. More information about the EPSDT RACs can be found on the page under “Chapter 410 Division 151.”
- Meet with EPSDT staff this summer. We can meet just with you or your organization. We can also set up a group listening session at a time that works best for your community.
- Provide input through the public comment process this fall. To receive a notice when the public comment period opens, sign up for OHP rulemaking notices.
Interested in a RAC or other meeting or have any questions? Email EPSDT.Info@odhsoha.oregon.gov or call 503-891-9335 and let us know!
Accessibility statement:
Everyone has a right to know about and use OHA programs and services. OHA provides free help. Some examples of the free help OHA can provide:
- Sign language and spoken language interpreters
- Written materials in other languages
- Braille
- Large print
- Audio and other formats
If you need help or have questions, please contact Liz Stuart at 503-891-9335, 711 TTY, or EPSDT.Info@odhsoha.oregon.gov
 Provider updates
Recent rule revisions
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