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) 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.
Starting Aug. 14, 2023, Provider Services will no longer perform basic claim status and member eligibility checks for providers
If you need to quickly check on fee-for-service claim status or OHP member eligibility, please use one of OHA's free self-service options instead of calling Provider Services.
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Oregon Administrative Rule 410-120-1140 requires providers to check eligibility using the MMIS Provider Portal, Automated Voice Response (AVR) or Electronic Data Interchange (EDI).
- Providers can also check the status of all fee-for-service claims submitted to OHA using the Provider Portal, AVR or EDI.
 Now available: Frequently asked questions about EPSDT
A Frequently Asked Questions (FAQ) document is now available regarding the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program. The FAQ addresses questions from coordinated care organizations, OHP providers, and others. Please share with anyone who may be interested.
Questions? Contact EPSDT.Info@odhsoha.oregon.gov
 Clarification of coverage for vision exams and corrective lenses
The OHP Plus (BMM, BMH, BMD) and CWM Plus (CWX) benefit packages cover routine eye exams (CPT codes 92002-92014, with primary diagnosis Z01.00) for any eye condition as follows:
- Once every 24 months for adults age 21 or older with the OHP Plus (BMM, BMH, and BMD) benefit package.
- When clinically appropriate for OHP Plus members under age 21 and CWM plus (CWX) members.
Corrective lenses are only covered if the member is under age 21, pregnant, or has a condition related to aphakia or keratoconus:
- Keratoconus, unspecified
- Keratoconus, stable condition
- Keratoconus, acute hydrops
- Aphakia
- Congenital aphakia (congenital absence of lens)
- Absence of eye lens(es), such as following cataract extraction
 Providing meaningful access to language services
Providers must ensure all services, including telehealth/telemedicine services preserve meaningful access to language services as described on the Office of Civil Rights website and in OHA's language and disability access page. This includes but is not limited to:
- American Sign Language (ASL) interpretation services to individuals who are Deaf or Hard of Hearing and
- Spoken language interpretation services for individuals with limited English proficiency (LEP).
Interpreter services must be free, timely and protect the privacy and independence of the LEP individual. The interpreter must be a certified or qualified health care interpreter (HCI). This can be:
- An interpreter on OHA's current HCI registry or
- Any other interpreter that meets the qualifications required by state and federal law.
 Join OHA’s quarterly collaboratives for therapy and vision services providers
Join OHA's next quarterly Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) provider collaborative:
- Date: Sept. 13, 2023
- Time: 10 to 11:30 a.m.
OHA will host its quarterly Visual Services Collaborative
- Date: Sept. 25, 2023
- Time: Noon to 1:30 p.m.
OHA is excited to welcome and hear from all individuals related to these program areas at these collaboratives and are always seeking new collaborators.
To join, please email your interest to Napua Rich at NapuaAnn.K.Rich@oha.oregon.gov.
 OHA seeks comments on proposed changes to OHP telehealth rules: Comments due Aug. 21, 2023
OHA is updating the OHP telehealth rules (410-120-1990 and 410-141-3566) to:
- Permanently adopt telehealth as a covered health care service delivery model,
- Clarify medically appropriate and clinically indicated uses of telehealth service delivery, and
- Align with coverage guidance in the Prioritized List of Health Services and Guideline Note A005.
To submit written comments about these rules, please email hsd.rules@oha.oregon.gov no later than Monday, Aug. 21, 2023.
 Other updates
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