Using the OHP 3165 Agreement to Pay form is an exception to OAR 410-120-1280
ORS 414.066 prohibits Providers from asking an individual enrolled in OHP to pay for services regardless of whether the service is covered or non-covered.
Providers may not bill members for health care services unless requested by the member
In addition, regardless of whether OHP covers the service:
- Members can choose to privately pay for the service.
- Providers cannot ask members to pay for the service.
- Only the member can initiate an agreement to pay for the service.
Oregon Health Authority (OHA) is updating the OHP 3165 (Agreement to Pay) form and OAR 410-120-1280 to make this clearer.
These requirements apply to all health care providers who serve OHP members, even if they are not currently enrolled as an open card or coordinated care organization provider.
Many thanks to those who recently completed our survey intended to capture feedback for the Behavioral Health Billing Guide. Many of you expressed interest in more opportunities to provide feedback and support our efforts in updating the Guide. If interested, please register for one of the following Listening Sessions:
At these sessions, we will share key themes learned from the survey and engage your perspectives on resources and information to incorporate into the updated billing guide. Your feedback will help ensure the guide is clear, accurate, and practical for organizations providing behavioral health services.
Thank you in advance for sharing your experience and perspectives.
If you have any questions, please reach out to Morgan Wilson at mwilson@healthmanagement.com.
Meeting accommodations:
For people who speak or use a language other than English, people with disabilities or people who need additional support, we can provide free help. Please email at jeffrey.s.good@oha.oregon.gov or call 503-979-8938. We accept all relay calls.
Provider resources
Approved Culturally and Linguistically Specific Providers (5/8/2026)
Recent rule revisions
None at this time.
For clinicians: Share your thoughts and feedback with OHP medical leadership at June 16 "Clinical Connections"
Please join OHP's Medical Leadership Team at these quarterly sessions to:
- Stay informed and learn about OHP program updates and expanded coverage.
- Help OHA doctors understand how changes to OHP may affect your work and the OHP members you serve.
- Share your questions, concerns, insights, and innovative ideas about OHP coverage and service delivery.
- Collaborate with us on the most effective ways to connect and share information with you throughout the year.
If you are unable to attend, please encourage another clinical colleague from your organization to attend on your behalf.
Meeting accommodations:
For people who speak or use a language other than English, people with disabilities or people who need additional support, we can provide free help. Please email at dan.cox@oha.oregon.gov or call 503-979-8594. We accept all relay calls.
For new providers and staff: June 10 fee-for-service Medicaid orientation
If you are new to OHP, be sure to join OHA's next webinar session about navigating fee-for-service Medicaid:
- Date: Wednesday, June 10
- Time: 10 to 11 a.m. Pacific Time
What you will learn:
- How to use the OHP Provider Resources website at OHP.Oregon.gov/Providers and provider tools
- Steps to receive payments
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Billing through the MMIS Provider Portal at https://www.or-medicaid.gov
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Checking eligibility for services
- And much more to support your success!
This is a great opportunity to get familiar with essential resources, ask questions and build confidence in working with OHA.
Meeting accommodations:
For people who speak or use a language other than English, people with disabilities or people who need additional support, we can provide free help. Please email Medicaid Provider Training at ProviderTraining-Medicaid@oha.oregon.gov or call 800-336-6016. We accept all relay calls.
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