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).
OHA is hosting a series of virtual open office hours to talk about the Young Adults with Special Health Care Needs (YSHCN) program.
- YSHCN is a new Medicaid program that provides access to OHP benefits.
- At the beginning of each hour-long session, Max Derenoncourt, OHA's YSHCN Policy Lead, will provide a brief overview of YSHCN and take questions from those in attendance.
- All are invited to attend.
Daytime office hours: Tuesdays, 10 a.m. Pacific Time
- Feb. 4 and 18, 2025
- March 18, 2025
- April 1 and 15, 2025
Evening office hours: Tuesday, 6 p.m. Pacific Time
This meeting will be virtual-only. This meeting will screen share and use a PowerPoint presentation. If you have questions or if you need an accommodation, please contact us right away at 1115waiver.renewal@odhsoha.oregon.gov even if you are only considering attending. The earlier you make a request the more likely we can meet the need.
Upcoming rule change process for board-registered behavioral health associates and mental health interns
This spring, OHA will begin rulemaking related to registered mental health interns and pre-licensed behavioral health associates. OHA plans to finalize the rule Dec. 31, 2025. Under the proposed rule:
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Until June 2026, these providers may bill OHA for services to OHP fee-for-service ("open card") members and render behavioral health services under supervision.
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After June 2026, they must either become fully licensed or work for a certified or licensed behavioral health organization.
Previously, interns and associates could render OHP services if employed or supervised by a licensed behavioral health provider. To employ an intern or associate to render OHP services after Dec. 31, 2025, providers will need a Certificate of Approval (COA) from OHA.
Local education agencies (LEAs) do not currently qualify for a COA. OHA and Oregon Department of Education are engaging with LEAs to explore ways to ensure access to mental health professionals in LEA settings.
These changes will help ensure all publicly funded behavioral health services meet the same standards across Oregon.
 Weekly claim reprocessing to begin Jan. 31, 2025
OHA plans to reprocess fee-for-service claims paid on or after April 1, 2023. This is to adjust funding information on the claims. This activity will not change any payments already made to you.
Questions? Please contact Provider Services at 800-336-6016, option 5.
Feb. 3, 2025 webinar about adult mental health residential rates
OHA is hosting a provider webinar to confirm the final rate increase, outline the timeline for implementation, and respond to questions.
- Date: Monday, Feb. 3, 2025
- Time: 2 to 3 p.m. Pacific Time
Provider resources
Carve-Out Drug List, 4th Quarter 2024 (1/30/2025)
English and Spanish Sterilization Consent Forms (1/28/2025)
Oregon Medicaid Pharmaceutical Services Prior Authorization Criteria (1/22/2025)
Change log for the Jan. 1, 2025 Prioritized List of Health Services (1/21/2025)
Recent rule revisions
None at this time.
In case you missed it
Updated Benefit Update Project Workplan (1/31/2025)
Health Evidence Review Commission vacancy: Consumer representative (1/28/2025)
New dashboard tracks OHA's progress with OHA Strategic Plan (1/30/2025)
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