Updates for Oregon Health Plan (OHP) 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 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).
Two major grocery store chains — Kroger and Albertsons — are planning to merge. This deal could impact more than 150 pharmacies in Oregon.
OHA reviews these types of health care business deals to make sure they won’t harm people and communities in Oregon. To support our review of the Kroger and Albertsons deal, we are forming a community review board, made up of community members, providers, health care experts and community groups. This group will provide input about potential effects of the deal and make a recommendation to OHA about whether the deal should proceed as planned.
We’re looking for community review board members! To apply, fill out an application and submit to hcmo.info@oha.oregon.gov by Jan. 19, 2024. People with these experiences are encouraged to apply:
- Fred Meyer, Safeway, Albertsons, or QFC pharmacy customers
- Pharmacists or pharmacy technicians
- Health care providers who write prescriptions
- Consumer advocates
To learn more about becoming a community review board member, you can visit our website or email us at hcmo.info@oha.oregon.gov.
If you want to share a public comment, please email hcmo.info@oha.oregon.gov and include the word “Kroger” in your message.
Hosted by Northwest ADA Center in collaboration with OHA, this webinar series focuses on ensuring accessibility and inclusivity within health care environments through Americans with Disabilities Act (ADA) compliance.
These sessions will cover critical topics such as creating accessible environments, effective communication, reasonable modifications, and much more.
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Disability Foundations: Thursday, January 25, noon to 1 p.m.
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Physical Access and Telehealth: Tuesday, February 27, noon to 1 p.m.
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Effective Communication and Reasonable Modification: Wednesday, March 24, noon to 1 p.m.
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Examining Ableism in Healthcare: Recent Research on Explicit and Implicit Disability Bias among Healthcare Providers: Week of April 15 (date and time to be determined)
Visit verifications not required for travel to access substance use disorder (SUD) treatment or Women, Infants and Children (WIC) program services
Effective immediately, OHA asks non-emergent transportation (NEMT) brokerages to verify appointments with WIC or SUD treatment locations as follows:
- When arranging the rides, staff must confirm WIC or SUD appointments with the OHP member without separate confirmation.
- Brokerages cannot separately confirm the appointment with the WIC or SUD clinic.
Brokerages must continue visit verifications with all other provider offices and appointment locations.
 Billing OHP for refugee health screenings, effective Jan. 1, 2024
OHA is adding ICD-10 diagnosis code Z65.5 (Exposure to disaster, war and other hostilities) to line three of the January 1, 2024 Prioritized List of Health Services. This allows
OHP to cover domestic medical screenings for refugees who arrive in Oregon.
When billing OHP for these screenings on or after Jan. 1, 2024, providers should list Z65.5 as the primary diagnosis.
Updated Electronic Visit Verification Reporting Template for home health agencies
OHA has updated the Electronic Visit Verification (EVV) Reporting Template. Please be sure to use the most current form found in the Forms section of the Home Health policy page.
Provider resource updates
Approved Culturally and Linguistically Specific Services providers (12/14/2023)
Mobile Crisis Intervention Services and Stabilization Services Billing Guide and Frequently Asked Questions (12/8/2023)
Slides and recording from December 2023 EPSDT webinars (Overview and Open Card Process Updates):
Translations of member fact sheet about OHP orthodontic coverage:
Recent rule revisions
OAR 410-120-0000, 410-120-1180, 410-120-1200, 410-120-1260, 410-120-1340, 410-120-1360, 410-120-1400: Add Definitions, Remove Outdated Language, Align with CMS, and Improve Clarity
Other updates
Annual CARES participation report for Ground Emergency Medical Transportation Coordinated Care Organization Supplemental Payment Program (12/5/2023)
From the Health Evidence Review Commission:
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