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Oregon Health Plan provider enrollment

Oregon Health Authority requirements

Click the boxes below to learn what you need to submit to the Oregon Health Authority (OHA) to enroll as an Oregon Health Plan provider, update your information, or maintain your current enrollment.

OHA enrollment forms

All forms are fillable PDFs. Please fill out electronically. Handwriting is required for signature fields only. If you use Mozilla Firefox, you may need to change your download settings to see the fillable version.

To be sure you are using the most current versions of OHA’s enrollment forms, please use only the forms posted below. OHA only accepts previous versions of posted forms for three months after the revision date. For example, if a form is revised in April, OHA will only accept the older version through July.

Other requirements

Sanctioned providers

To find out about providers who have been prohibited from serving Oregon Medicaid clients, search the list below. You can also search the OHA Medicaid Program Integrity Audit Unit's list of State Medicaid Fraud Convictions.

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