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 OHA incorrectly reported the status of Community Investment Collaboratives as pending and in negotiation with CMS. This proposal will not move forward at this time and is not scheduled for future negotiations with CMS. We in OHA are sorry for the confusion and harm our error has caused.
In this Issue:
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Welcome to the first newsletter about the Oregon Health Plan (OHP) 1115 Medicaid Waiver.
This email will provide basic information and updates about the OHP 1115 Medicaid Waiver. Content will include hot topics, resources, and information about upcoming events. OHA wants to make sure that everyone who needs it, has information about this important initiative.
Every state must follow a standard set of rules determined by the federal government on how to operate. States can, however, ask the federal government for permission to set aside their Medicaid rules. To obtain approval, states must apply for what’s called a waiver. Waivers can allow state Medicaid programs to cover more people, cover more benefits, or deliver care in a different way. Oregon renews its waiver every five years and was just approved for new flexibilities in September 2022.
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- Keep children on OHP covered from birth to age six. Starting January 1, 2023, this means families do not need to renew OHP benefits to keep children covered and can get the health care their child needs in their most formative years.
- Keep OHP members ages six and up covered for two years before they need to renew (instead of one).
- Cover more health services for people from birth to age 21.
- Cover health-related social needs, starting in 2024 for eligible OHP members. This includes support for food, housing, and climate-related resources.
- Provide enhanced coverage for youth with special health care needs ages 19 – 26 with income up to 300% of federal poverty level.
The federal government also approved coverage for Health-Related Social Needs (HRSNs), including housing, nutrition, and climate-related needs for OHP members who are facing certain life transitions. How Oregon prioritizes eligible populations and ensures access to these services will be the focus of planning efforts, which will involve extensive community and partner input. The rollout of HRSN services will occur throughout 2024 and 2025. Additional information about the timeline for HRSN benefits is available in OHA’s recent news release.
For immediate help finding resources for health-related social needs, OHA’s community resource page provides more information.
- Tribal requests
- Limited benefits for some transitioning out of Oregon State Hospital and criminal justice settings
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Webinars: The OHA community engagement team hosts monthly webinars in English and Spanish with topical overviews and upcoming milestones. These meetings provide space for attendees to ask questions about the waiver and provide OHA with feedback. All 1115 waiver webinar presentation videos and slides can be found on the waiver website.
Get involved: Stay subscribed to this newsletter to learn more
Community assistance: Find community resources if you know someone who needs health-related services now
News: Read the latest news about the waiver, “Oregon to leverage Medicaid benefits to prevent homelessness, support behavioral health services, mitigate the impacts of climate change, pending federal approval”
Discover: Access documents that OHA has submitted to the Centers for Medicare and Medicaid (CMS), including the draft HRSN Infrastructure and Services Protocol and the draft New Initiatives Implementation Plan
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