Text Size:   A+ A- A   •   Text Only
Oregon Health Authority

  • Coordinated Care Organizations
    capital building
    The U.S. Department of Health and Human Services has given preliminary approval of a five-year, $1.9 billion demonstration of a Federal-State partnership to transform the way we deliver care to Oregon Health Plan recipients. This will allow Coordinated Care Organizations to deliver high-quality, coordinated care for Medicaid patients while reducing preventable health conditions. Oregon estimates that this will achieve $11 billion in savings over the next decade.

    The Oregon Health Authority is now preparing to receive comments about the CCO Administrative Rules that help form the policies and procedures CCOs will follow starting August 1.

    We encourage you to attend one of the rules advisory committee meetings. All meetings are open to the public. A public comment period will be available at the end of each meeting.

    The committee will meet four times at the Oregon Employment Department auditorium, located at 875 Union St. NE, Salem, OR 97301. The dates and times are:

    - May 10, 1:30 p.m. to 3:30 p.m.
    - May 14, 2:00 p.m. to 4:00 p.m.
    - May 16, 2:00 p.m. to 4:00 p.m.
    - May 18, 1:30 p.m. to 3:30 p.m.
  • Providers - Health reform information
    information for providers
    Right now, there are many changes for health care providers in Oregon. Information on health reform efforts that may affect providers is available through the health.oregon.gov Health care providers page. You can learn more about:

    • Coordinated Care Organizations (CCOs)
    • Administrative simplification of electronic health care transaction standards (Senate Bill 94)
    • The Medicaid Electronic Health Record Incentive Program
    • Patient-Centered Primary Care Home Program
  • Providers, plans and clearinghouses:
    30 days left for 5010 compliance with DMAP CMS extends 5010 discretionary enforcement period
    After June 29, DMAP will no longer exchange information using 4010 transactions or mailboxes. In order to exchange information with DMAP in 5010 or NCPDP 1.2 formats after this date, make sure that:

    1) You or your authorized submitter successfully completes 5010 third-party and business-to-business(B2B) testing with DMAP for inbound transactions (e.g., 837) by Friday, June 1 for 5010 mailbox access; and

    2) You are able to use the Provider Web Portal, Automated Voice Response, commercially available paper claims and/or the paper remittance advice for any transactions that do not pass 5010 testing.

    DMAP will continue to accept 4010 transactions after Mar. 30. However, continued delivery of 4010 versions of the 834, 835 and 820 transactions requires your good faith efforts to complete 5010 registration and testing.
  • Health care providers - Get ready for ICD-10
    Centers for Medicare & Medicaid Services (CMS) ICD-10 Website
    The federal Department of Health and Human Services (HHS) recently announced plans to delay the Oct. 1, 2013 ICD-10 compliance date. Meanwhile, DMAP continues compliance planning for ICD-10 implementation. If you bill DMAP or an OHP managed care plan for services to OHP clients, this means:

    If you haven't already, make sure your billing system complies with HIPAA 5010 standards and DMAP's specific billing requirements. You have until June 29, 2012 to become 5010 compliant. Learn more at www.oregon.gov/OHA/edi/5010.shtml.

    If you are already 5010-compliant, make sure your processes and systems for medical records and coding will be ready to use the ICD-10 code sets.
  • EHR incentives for hospitals and eligible professionals
    Medicaid EHR incentives
    Right now, eligible health care providers in Oregon can apply for incentives to help implement and meaningfully use electronic health records in their clinics.

    Since the Medicaid EHR Incentives Program started in late September, over $55 million in federal incentive payments have been paid to Oregon Medicaid hospitals and eligible professionals.

    If you would like to apply for incentive payments:

    -- Register on the federal incentive program Web site;
    -- Make sure you have Provider Web Portal access to the "EHR incentive" screen. This may require you to enroll as a DMAP provider if you haven't already;
    -- Collect patient volume data that shows you meet Medicaid EHR incentive program criteria;
    -- Apply on the Provider Web Portal.
Quick links
EDI Updates
Other OHA Links
EDI Tools
EDI Registration
For EDI Submitters
Frequently Asked Questions