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
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 related to COVID-19.
Review what is ending and continuing with the May 2023 end of the COVID-19 Public Health Emergency: 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 webinars
Join ODHS and OHA for webinars about how the two agencies are working together to wind down the COVID-19 Public Health Emergency. The September agenda includes:
The recording and presentation slides from the September 12 webinar are now available. Learn about:
- Information about new Pandemic EBT (P-EBT) food benefits for children.
- Updates on SNAP time limits for people with Able-bodied Adults Without Dependents (ABAWD) status.
- Progress on eligibility redeterminations for Oregon Health Plan (OHP) and other Medicaid benefits.
- Resources for partners, including how to order free Keep Covered campaign materials.
Webinars are held in English and Spanish from 10 to 11 a.m. Pacific Time.
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English webinar: November 14.
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Spanish webinars: September 26 and November 16.
Language and disability access:
American Sign Language and live closed captioning will be available for these webinars.
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. If you would like help to participate in the webinar, contact the Feedback Team at 503-945-5488 or feedback@odhsoha.oregon.gov at least two business days before the webinar. All relay calls accepted.
CareOregon is a prominent provider of Medicaid benefits in Oregon. CareOregon plans to combine with a company called SCAN Group. They plan to create an organization that will provide Medicaid and Medicare coverage in multiple states.
Oregon Health Authority (OHA) reviews these types of health care business deals. This review makes sure the changes won’t harm people and communities in Oregon. OHA is hosting two public listening sessions to hear what you think about this deal:
The listening sessions are 7 to 8:30 a.m. and 4:30 to 6 p.m. Pacific Time.
SCAN Group is a California-based non-profit company focused on providing health benefits to older adults. It offers Medicare Advantage plans and health care services. CareOregon provides benefits for members of three coordinated care organizations (CCOs) in Oregon. The three CCOs, Columbia Pacific CCO, Health Share of Oregon, and Jackson Care Connect, serve more than 500,000 members in seven counties.
Anyone can attend the listening session and share a public comment. OHA wants to understand how the deal could affect health care for people in Oregon. We want to hear from:
- CareOregon, Columbia Pacific CCO, and Jackson Care Connect members
- Providers in CareOregon’s network
- Community organizations that work with CareOregon
- Concerned members of the public
Public comment will be used to inform OHA’s review and may be included in publications.
To learn more about the listening sessions, you can visit our website or email us at hcmo.info@oha.oregon.gov. If you want to share your comments in writing, please email hcmo.info@oha.oregon.gov. Include the word “CareOregon” in your message.
Learn about the CCO Social Determinants of Health screening metric and how providers can partner with CCOs to support screening for social needs
Café Connect events are an opportunity to hear from experts, engage in dialogue, strengthen partnerships and support successful implementation of social needs screening.
The September 18 orientation offered an overview of metric requirements:
CCOs, community-based organizations, social services providers, and other providers who can partner with CCOs to refer members are welcome to join the rest of this series:
- October 24: Health and Social Care Integration: Sustainable Partnerships
- January 23: Payment Arrangements for Social Needs Screening and Referral
- March 18: Establishing Data Sharing Approaches and Agreements
- May 23: Optimizing Data Sharing Systems
All sessions are from 1 to 2 p.m. Pacific Time.
Questions? Email Rachel Burdon (Rachel.E.Burdon@oha.oregon.gov) or Claire Londagin (londagin@ohsu.edu).
Starting Nov. 1, 2023, OHP covers flu vaccine administration for members under age 19 only when provided through the Vaccines for Children (VFC) program
This means:
- OHP will no longer cover children's flu vaccine administration provided at non-VFC locations.
- Primary care providers should refer families to VFC locations for these vaccinations
 Non-participating provider reimbursement for child/adolescent psychiatric units, effective July 1, 2023
OHA updated Oregon Administrative Rule (OAR) 410-120-1295 (Non-Participating Provider) to allow CCOs to use Medicare's Diagnosis-Related Group (DRG) methodology to calculate reimbursement for services provided by child/adolescent psychiatric units.
This change will continue until OHA establishes a new per diem rate for child/adolescent psychiatric unit reimbursement. When a new rate is final, OHA will update the Non-Participating Provider rule.
 Fee-for-service rate increases for dental services effective Oct. 1, 2023
Pending Centers for Medicare & Medicaid Services (CMS) approval, OHA will increase the fee-for-service (FFS, or “open card”) reimbursement rates for all covered dental services billed with Current Dental Terminology (CDT) codes.
- OHA expects CMS approval no later than Dec. 31, 2023.
- Upon CMS approval, OHA will update rates to apply the increase to services provided on or after Oct. 1, 2023.
OHA is analyzing each CDT code in the FFS fee schedule to determine the rate increase for each code. When this work is complete, OHA will send another memo about the new rates.
 Provider resource updates
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Provider Enrollment Guide (8/31/2023): Learn how to submit provider enrollment information using the MMIS Provider Portal at https://www.or-medicaid.gov
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Healthier Oregon mailing (9/8/2023): Samples of letters mailed to members moving from Citizenship Waived Medical to full OHP benefits
Recent rule revisions
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OAR 410-136-3370: Ground Emergency Medical Transportation (GEMT) Fee For Service Supplemental Payment (9/19/2023)
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OAR 410-172-0670: Amends Overarching Telemedicine Rule Authorizing Coverage Of Remote Health Care Services Delivered Using Telecommunication Technologies (9/19/2023)
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OAR 410-120-1990, 410-141-3566: Amends Overarching Telemedicine Rule Authorizing Coverage Of Remote Health Care Services Delivered Using Telecommunication Technologies (9/13/2023)
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