Skip to main content Homepage

Provider Matters

Provider Matters is an email communication that gives Oregon Health Plan providers timely updates, tips and resources related to fee-for-service benefit coverage, criteria, policies and procedures.

 Subscribe to receive the newsletter by text or email

Current issue

Initial therapy for newer antineoplastic drugs will require prior authorization effective October 1, 2020; contact for applied behavior analysis authorization requests; OHP coverage of home blood pressure monitoring services during the COVID-19 emergency; apply for federal Provider Relief Fund applications by September 13, 2020; Health Evidence Review Commission changes effective October 1, 2020; CCO enrollment reminders and updates; Medicaid Program Integrity resources for dental professionals; free training to become a qualified health care interpreter


8/21/2020The Medicaid Advisory Committee is recruiting a physician member
8/14/2020 Prioritized List; OHP coverage of COVID-19 testing; clarification about COVID-19 testing requirements for long-term care facilities; apply for federal Provider Relief Fund applications by August 28, 2020: provider survey on interpretation services in Oregon; apply for 2020-2021 DELTA cohort by August 31, 2020; ICYMI: Postcards claiming to be from OCR
8/7/2020Provider Relief Fund application deadline extended to August 28
Deadline for federal Provider Relief Fund applications extended to August 28, 2020; Interim stability payments (short-term loans) for fee-for-service providers experiencing difficulties associated with COVID-19: updated COVID-19 FAQs and guidance; OHP 3047 Augmentative Communication Device Support Summary
7/24/2020Provider Relief Fund application deadline extended to August 3, 2020
Deadline for federal Provider Relief Fund applications extended to August 3, 2020; COVID-19 updates; recent rule revisions
7/10/2020Updated enrollment form for rendering providers
Updated enrollment form for rendering providers; view your remittance advice online; updated COVID-19 provider guide; apply for federal Provider Relief Fund Medicaid distribution by July 20; other COVID-19 resources for health care providers; Diabetes Prevention Program webinars for CCOs, community-based organizations and clinics
6/26/2020Changes to ACA 1557 do not affect OHP coverage of gender transition services
ACA 1557 and OHP coverage of gender transition services; fee-for-service claim processing updates; COVID-19 provider resources; new Independent and Qualified Agent for Medicaid-covered behavioral health services effective July 1, 2020; recent rule revisions
6/12/2020Financial supports for providers during COVID-19
Apply now for next round of federal Provider Relief Fund General Distribution; bill HHS for COVID-19 testing and treatment of uninsured individuals; OHP coverage of COVID-19 testing;  full-day virtual training on motivational interviewing and patient-centered counseling (no-cost CME available)
5/22/2020Questions about telemedicine/telehealth?
Questions about telemedicine/telehealth? OHP COVID-19 updates - April 17 webinar Q and A, updated COVID-19 Provider Guide and how to provide culturally and linguistically appropriate services during the COVID-19 emergency; additional COVID-19 updates for all providers from OHA, FDA and HHS
5/8/2020Corrections to behavioral health fee schedule
Corrections to behavioral health fee schedule; how to adjust claims paid by OHA; temporary expansion of CAWEM-only coverage during the COVID-19 emergency; Oregon Medicaid COVID-19 provider guide; guidance for resumption of non-emergent and elective procedures; OHSU Connected Care Center hotline for managing patients with COVID-19; HHS Office of Civil Rights updates;  temporary eligibility policy changes related to the COVID-19 emergency period
4/24/2020OHA launches OHA en Español Facebook page
OHA launches OHA en Español Facebook page; COVID-19 provider resources and updates; Governor Brown and OHA launch Safe + Strong outreach campaign in 12 languages; non-urgent medical procedures to resume May 1 with safeguards in place; recent rule revisions
4/10/2020New secure email options for OHP providers; updated COVID-19 provider resources
New secure email options for OHP providers; updated COVID-19 provider resources; alert from federal Office of Civil Rights - Individual Posing as OCR Investigator; recent rule revisions
3/20/2020Fee-for-service prior authorization updates; more COVID-19 and CCO 2.0 provider resources;
Use the current Prior Authorization Request form with coversheet; visit the new COVID-19 (novel coronavirus) resources page for OHP providers and plans; questions and answers from OHA's 2020 CCO 2.0 webinar now availableOHA Transformation Center Offers free, quick online Tobacco Cessation Counseling Training (with CME); recent rule revisions
3/6/2020March 2020 due dates, language access policies, COVID-19 and CCO 2.0 provider resources
Nominate topics for HERC evidence-based reports and coverage guidanes by Mar. 30; Medicaid EHR Program Year 2019 attestations due Mar. 31; all Medicaid providers must offer language access services; COVID-19 page and updates; Lane County CCO 2.0 webinar; diabetes prevention webinar; recent rule revisions
2/21/2020Lane County and Census 101 webinars, billing updates and reminders
Lane County providers: Join OHA and your local CCOs at a Feb. 25 webinar; 2019-2020 claims to be selected for upcoming Payment Error Rate Measurement review; provider reimbursement updates; reminders for submitting paper claims and prior authorization requests; more OHA provider training opportunities (Census 101; online tobacco cessation counseling training with CME)
2/7/2020Billing resources, updates and reminders
CCO 2.0 provider resource updates; do not bill members for services approved by the member's 2019 CCO; expanded orthodontia coverage effective Jan. 1, 2020; speech and therapy claims no longer require prior authorization; Rules Advisory Committee invitation for Administrative Examinations program
1/24/2020New - Resources for working with Jackson County CCOs, billing OHP and more
Jackson County webinar recording, materials now available; fee-for-service billing reminders;  when billing for maternity care using global codes, bill OHA or the CCO based on the mother’s enrollment status on the day of delivery; OR-ESSENCE in action: How complete coding at discharge helps inform Oregon's public health surveillance system; no-cost technical assistance opportunities; recent rule revisions
1/10/2020CCO 2.0 updates: Jackson County provider webinar, web updates
CCO 2.0 updates: Jackson County provider webinar, web updates; starting the conversation about tobacco cessation; Transformation Center Updates – No-cost technical assistance opportunities
12/20/2019CCO 2.0 - Provider questions and answers, CCO rule revisions
CCO 2.0 updates: Webinar questions and answers now available; recent rule revisions
12/13/2019CCO 2.0 - December member letters, pharmacy fact sheet, more 5-year CCOs
CCO 2.0 updates: Member letters and fact sheet updates; OHA approves AllCare, Cascade Health Alliance, Umpqua Health Alliance and Yamhill Community Care for full five-year CCO contracts; January 1, 2020 Prioritized List of Health Services; fee-for-service billing updates and reminders; recent rule revisions
11/22/2019CCO 2.0 - Nov. 21 webinar video and slides now available
Free technical assistance for clinics: Alcohol & Opioid Management; from CMS: Medicare claims using Health Insurance Claim Numbers will reject starting Jan. 1, 2020; recent rule revisions
11/8/2019CCO 2.0 - Join OHA's Nov. 21 provider webinar
OHA to host CCO 2.0 provider webinar; CCO changes by county; fee-for-service prior authorization tips and resources; updated National Diabetes Prevention Program billing guidance
1 - 20Next

Your browser is out-of-date! It has known security flaws and may not display all features of this and other websites. Learn how