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DHS news release

July 23, 2004

Contact: Jim Sellers (503) 945-5738
Program contact: Jim Edge (503) 945-5769

Oregon receives federal approval to restructure OHP-Standard benefits

The state received federal approval Friday afternoon to make planned Aug. 1 changes to the Oregon Health Plan's Standard benefit package, which now covers about 55,000 low-income Oregonians.

Cindy Becker, Oregon Department of Human Services (DHS) deputy director, said changes in the Standard benefit package authorized by the 2003 Legislature will add outpatient mental health coverage, chemical-dependency coverage, emergency dental and limited coverage for medical equipment, while reducing hospital coverage to a limited benefit.

The changes restructure Standard benefits that were reduced in early 2003 to help balance the state budget.

Jim Edge, assistant state Medicaid director in DHS, said officials with the federal Centers for Medicare and Medicaid Services also approved moving by three lines coverage on the Oregon Health Plan's prioritized list of medical conditions and services. None of the three conditions that will no longer be covered is a life-threatening condition.

As a result of federal approval, DHS is using overnight mail to notify the 31 managed care insurance plans that serve OHP clients, Edge said. The managed care plans were already preparing for the changes, he said, and notification will enable them to finalize plans.

Another major change in the Standard plan is that it will no longer receive state general-fund support, but will instead be financed by provider taxes and matching federal funds. Federal officials have approved a tax on managed care insurance plans, and a tax on selected hospitals is pending federal approval.

The Standard plan was closed to new enrollments on July 1.