This page provides information for OHP stakeholders: providers, clients, organizations and other partners interested in how the Oregon Health Plan works.
About Centers for Medicare and Medicaid Services (CMS)
The federal Centers for Medicare and Medicaid Services (CMS) oversee and fund state Medicaid and SCHIP programs, administer Medicare, and oversee HIPAA/NPI implementation. CMS approved waivers of federal Medicaid requirements that allow Oregon to expand its Medicaid program to include an expansion population under the OHP Standard program, and allow Oregon to use the Prioritized List of Health Services to determine service coverage.
- SCHIP - Detailed information about Oregon's CHIP can be found on the CMS website by selecting "CHIP-Approved State Plan Information," on the left-hand menu; then select "Show only items whose State is Oregon" on the resulting page.
DMAP is a division of the Oregon Health Authority (OHA), which coordinates the biennial budget development process that funds DMAP operations. OHA also oversees initiatives such as Healthy Kids and the MMIS Replacement Project. You can also get more information about the OHA budget.
From 1989-1993, the Oregon Legislature passed a series of laws known collectively as the Oregon Health Plan. Senate Bill 27 (1989) extended Medicaid coverage to Oregonians with income below the federal poverty level and established a set of benefits based on a prioritized list of health services.
OHP is a public/private partnership made up of three main components:
Client and constituent resources
Policies, rules and guidelines
The OHP Policies page provides links to the current Oregon Administrative Rules and supplemental information for OHP health care providers and managed care organizations.