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).
Apply by April 4, 2025
Applications are open to join LEAP! OHA is looking for people who have used open card (fee-for-service) OHP or help others use open card OHP. LEAP gives advice to improve health care for open card members. This advisory group meets monthly on Zoom.
If you have questions or need help with the LEAP application:
Please contact Spencer Delbridge at medicaid.engagement@oha.oregon.gov or 971-304-6454. We accept all relay calls.
 Learn more about LEAP
OHA is holding virtual information sessions about LEAP in March. These virtual sessions will be in English with Spanish interpreters.
Reminder: Fee-for-service prior authorization request categories and processing times
OHA is consistently processing routine requests within one week from the submission date. If you need expedited processing:
- Mark your request as urgent if you need a decision within 3 business days.
- Mark your request as immediate if you need a decision within 1 business day.
Otherwise, OHA will process your request as routine. To note urgent or immediate requests:
- On web portal requests, enter this information in the "Notes" section of the request.
- On faxed requests, mark the appropriate box at the top of the EDMS Coversheet.
- Include clinical justification for all expedited requests.
Please be sure that all requests are complete, accurate, and include any required supporting health records.
Fee-for-service requirements for OmniPod insulin delivery systems
If you prescribe OmniPod insulin delivery systems for fee-for-service members, please refer to OHA's new guide about requesting prior authorization for OmniPod devices and supplies. The guide includes:
- Required National Drug Codes
- Coverage rules and guidelines
- Prior authorization requirements, required documents and related rules
Provider resources
Oregon Medicaid Covered Dental Codes (2/21/2025)
Inpatient Hospital Psychiatric Reimbursement Review: Questions and Answers (2/20/2025)
2025 Non-Contract Rates for Type A and B Hospitals (2/18/2025)
Administrative Exam Fee Schedule (2/18/2025)
Recent rule revisions
OAR 410-200-0315. Oregon Health Plan 2025 Federal Poverty Level (FPL) rule update.
In case you missed it
OHA seeks public comment on draft request to extend Oregon's SUD 1115 waiver (2/18/2025) - Submit comments by 5 p.m. Thursday, March 20, 2025
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