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 related to 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).
Thanks to House Bill 4109 (2024), Oregon families in multiple households can apply to receive more than one Family Disabled Parking Placard starting June 6, 2024.
This makes life easier for families providing care among households, whether it's caring for a child who shares their time between multiple homes, or adult children caring for their older parents.
To qualify for a Family Placard:
- Two or more members of a family must be disabled, or
- Two or more households must be caring for the same individual with a disability.
A licensed physician must certify eligibility of the family member who has a disability requiring the placard.
Please share this important change with patients, families and other health care partners who can spread the word.
OHA is hosting the next HRSN provider training on Tuesday, June 25, 2024, from 1 to 2:30 p.m. In this session, we will offer office hours for you to ask questions, get answers from subject matter experts, and learn more about the resources available for HRSN providers.
The session is open to all organizations who provide, or are interested in providing, HRSN support to OHP members.
Spanish simultaneous interpretation and closed captioning will be available. If you need support or accommodations to participate, please email 1115Waiver.Renewal@odhsoha.oregon.gov.
Ready to get started as an HRSN provider?
To begin the process of enrolling as an HRSN service provider, complete the Provider Enrollment application:
Once you've completed the application, please email the Provider Enrollment Team at provider.enrollment@odhsoha.oregon.gov letting them know that you submitted an application to become an HRSN Service Provider. This will ensure that your application can be processed sooner.
If you have additional questions about enrolling as an HRSN service provider:
Earlier this year, the U.S. Department of Health and Human Services (HHS) filed three final rules that take effect this summer:
Updates to Section 1557 of the Affordable Care Act., effective July 8, 2024. The updates strengthen nondiscrimination protections, accessibility and language access requirements. The rule also clarifies that nondiscrimination applies to decision support tools and use of artificial intelligence.
Depending on the requirement, covered entities have from 120 to 365 days after July 8, 2024, to comply.
 Updates to Section 504 of the Rehabilitation Act of 1973, effective July 8, 2024. The updates clarify that the nondiscrimination protections of Section 504 also apply to medical treatment decisions, value assessment methods, web/mobile services and medical equipment. They also ensure consistency with the Americans with Disabilities Act.
Updates to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, effective June 25, 2024. The updates strengthen the protection and privacy of reproductive health care information after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization leading to state abortion bans and other restrictions on reproductive freedom in 21 states.
Covered entities must comply with most aspects of the rule by Dec. 23, 2024, and update their Notice of Privacy Practices by Feb. 16, 2026.
OHA also hosted a May 22, 2024 roundtable discussion about these updates with HHS Director of the Office for Civil Rights, Melanie Fontes Rainer, regional HHS leaders and community partners.
Mental Health Statistics Improvement Program Survey
Last week, OHA began fielding the 2024 Mental Health Statistics Improvement Program Survey. Market Decisions Research will survey selected OHP members who received mental health care services in 2023. There are four versions of the survey:
- Adult outpatient,
- Adult residential,
- Parents or guardians of children and youth ages 0-17, and
- Youth ages 14-17.
A random sample of OHP members (or their parent/guardian) will get an invitation in the mail asking to complete the survey online or by phone. Some members will also have the option to complete the survey by mail. The invitation offers a $10 gift card to those who complete the survey. Participation is voluntary.
Fee-for-service participation in the transportation company network pilot for non-emergent transportation brokerages
Effective June 1, 2024, OHA updated Oregon Administrative Rule (OAR) 410-136-3020 to allow fee-for-service brokerages to participate in the transportation network company (TNC) pilot.
This would allow fee-for-service brokerages to continue to do the following after OHA’s temporary TNC authorization ends Feb. 15, 2025:
- Allow fee-for-service (open card) members to use approved TNCs (Uber and Lyft).
- Contract with approved TNCs to provide rides to fee-for-service (open card) members as needed.
After Feb. 15, 2025, only brokerages who participate in the TNC pilot may use TNCs as a ride option.
Fee-for-service rate increase for Medicaid behavioral health services, effective July 1, 2024
OHA is updating its fee-for-service claim system to reflect new reimbursement rates effective July 1, 2024. The increase:
OHA aims to have the 3.4 percent increase completed by the end of this month. When this work is complete, OHA will:
- Post communications on the Behavioral Health Rate Increase page.
- Post the new rates in the July 2024 Behavioral Health Fee Schedule.
- Adjust rates for adult mental health residential billing codes T1020 and T2033.
Provider resources
June 2024 Medical-Dental Fee-for-Service Fee Schedule (6/13/2024)
Peer-Delivered Services Billing Guide (6/13/2024)
Fact sheet: Changes in coordinated care organization enrollment (6/12/2024)
OHP Bridge Outreach toolkit (6/3/2024)
Early Periodic Screening, Diagnosis and Treatment (EPSDT) fact sheets and posters for partners (5/31/2024)
Recent rule revisions
OAR 410-136-3020. Non-emergent medical transportation rule changes to allow for the fee-for-service TNC pilot to start
OAR 410-148-0100. Amend language to comply with federal regulation regarding primary payer of formula and nutrition supplements.
Reminders
Only send confidential claims as follows:
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