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OHP Announcements

View announcements to OHP members, plans or health care providers.

Receive updates by text or e-mail

Select the type of announcements you want to view by category, date, name or audience using the drop-down boxes below. You can also use the search field to do a text search of all the fields below.

If you need a copy of an older announcement, e-mail Client and Provider Education at hsd.distribution@state.or.us.

Applies To
Provider5/31/2016Changes to Oregon Health Plan adult dental benefit effective July 1, 2016NewDental providers
Provider5/31/2016Provider Matters - May 2016NewAll Providers
Provider5/17/2016Reminder - Join OHA at the May Provider CollaborativeAll Providers
Provider5/3/2016July 1 2016 changes to applied behavioral analysis service contactsApplied behavioral analysis providers
Provider4/22/2016Indian Health Service all-inclusive encounter rate effective January 1, 2016Indian Health Service (IHS) clinics, Tribal 638 clinics
Provider4/22/2016Fee-for-service claims and Place of Service code 19Medical-surgical providers
Provider4/22/2016Provider Matters - April 2016All Providers
Provider3/23/2016Fee-for-service reimbursement of medical electrolysis servicesMedical electrolysis providers
Provider3/23/2016Fee-for-service professional claim reprocessing scheduled for March 26, 2016Medical-surgical providers
Provider3/23/2016Provider Matters - March 2016All Providers
Provider3/22/2016Fee-for-service RVU-weight-based rates effective April 1 2016Medical-surgical providers
Provider3/22/2016Fee-for-service rates for DHS-OHA private duty nursing services effective March 1, 2016Private duty nursing providers
Public notice3/18/2016Request for comments - State Plan Amendment for DHS Long-Term Care Changes - Comments due March 31, 2016All interested parties
Provider3/15/2016Fee-for-service outpatient claim reprocessing scheduled for March 18, 2016Oregon DRG hospitals
Provider3/11/2016Online remittance advices available starting March 20, 2016All Providers
Provider3/8/2016Requirements for out-of-hospital births effective December 1 2015Direct entry midwives, Medical-surgical providers, Midwives, Nurse practitioners
Provider2/19/2016Provider Matters - February 2016All Providers
Provider2/17/2016Fee-for-service hospice rates, effective October 1, 2015Hospice providers
Plan2/12/2016Coverage criteria for direct acting antiviral treatments of hepatitis CCCOs
Provider2/9/2016Fee-for-service inpatient claim reprocessing scheduled for February 12, 2016Hospitals
Provider2/9/2016Join OHA for Provider Appeals Webinar on Tuesday, February 16All Providers
Provider2/3/2016Billing for 2016 SBHS Medicaid services using accepted 2016 costsSchool-Based Health Services providers
Public notice2/1/2016Notice of intent to submit Section 1115 Waiver renewal application - Accepting comments February 5 through March 7, 2016All interested parties
Provider1/28/2016Changes to provider administrative review process effective March 1, 2016All Providers
Provider1/28/2016Fee-for-service RVU-weight-based rates effective January 1, 2016Medical-surgical providers
Provider1/22/2016Provider Matters - January 2016All Providers
Plan, Provider1/15/2016Changes to Provider Web Portal Eligibility Verification screen effective January 11, 2016All Providers, CCOs
Plan, Provider1/11/2016Rendering provider required on all behavioral health claims effective March 1, 2016Mental health providers, Substance use disorder treatment providers, CCOs, MHOs, Community Mental Health Programs
Provider12/23/2015Updates about January 1, 2016 AFH rate changesAdult foster homes, Community Mental Health Programs
Provider12/23/2015Provider Matters - December 2015All Providers
Provider12/16/2015Fee-for-service professional claim reprocessing scheduled for December 18, 2015Medical-surgical providers
Provider12/7/2015Fee-for-service claim reprocessing planned for December 11, 2015Medical-surgical providers
Plan, Public notice12/7/20152015-17 Competitive Application Process - Funding for Substance Use Disorder Day Treatment with Housing Support ServicesAll interested parties, Substance use disorder treatment providers, Tribal health centers, CCOs, Community Mental Health Programs
Provider12/3/2015Payment schedule and other changes start January 1, 2016Personal care attendants, Community Mental Health Programs
Provider11/30/2015Provider Matters - November 2015All Providers
Provider11/18/2015Planned out-of-hospital births will require prior authorization starting December 1, 2015Birthing centers, Direct entry midwives, Maternal health care providers, Maternity case managers, Medical practitioners, Medical-surgical providers, Midwives, Nurse practitioners, Physicians
Plan11/13/2015Outpatient Day Treatment with Housing Support Services funding opportunitiesCCOs, Community Mental Health Programs
Provider11/5/2015AFH rate setting changes effective January 1, 2016Adult foster homes, Community Mental Health Programs
Provider11/5/2015Fee-for-service inpatient claim reprocessing planned for November 20, 2015Oregon DRG hospitals
Provider10/16/2015Provider Matters - October 2015All Providers
Plan, Provider10/2/2015Oregon DRG hospital reimbursement under the Oregon Health PlanOregon DRG hospitals, CCOs
Provider9/29/2015Temporary process for adding ICD-10 codes to prior authorization approvalsAffected Providers
Provider9/24/2015Fee-for-service professional claim reprocessing scheduled for September 26, 2015Medical-surgical providers, Vaccines for Children providers
EDI Submitter, Provider9/21/2015ICD-10 Readiness Surveys now openAll Providers
Provider9/18/2015Provider Matters - September 2015All Providers
Plan, Provider9/16/2015ICD-10 Oregon Administrative Rule (OAR) updatesAll Providers, All plans
Provider9/16/2015ICD-10, FFS prior authorizations and prior-authorized claimsAffected Providers
Provider9/4/2015September 4 reprocessing of some fee-for-service physician-administered drug claims340B Drug Program providers, Ambulatory surgical centers, Family planning clinics, Federally Qualified Health Centers, Hospital, Medical-surgical providers, Rural health clinics, Tribal health centers
Provider9/4/2015Fee-for-service claim processing changes effective October 1, 2015Hospitals
Plan, Provider9/1/2015ICD-10 provider resource updates and webinarAll Providers, All plans
Plan, Provider8/27/2015SBHCs and medical sponsors – Use the UB modifier to identify medical and behavioral health services provided by SBHCsBilling providers (billing services, clinics, clearinghouses), Federally Qualified Health Centers, Public health departments, CCOs, Community Mental Health Programs
Provider8/24/2015Provider Matters - August 2015All Providers
Public notice8/14/2015Section 1115 Waiver Renewal Application for Oregon CCare Program - Comments due 9-18-2015All interested parties
EDI Submitter7/30/2015EDI Bulletin - ICD-10 Fee-for-Service Testing Begins August 3, 2015Electronic Data Interchange (EDI) trading partners, EDI submitters
Provider7/17/2015Provider Matters - July 2015All Providers
Provider7/10/2015July 1, 2015 changes to adult mental health residential services contactsAMH-licensed residential treatment providers, AMH-Licensed Adult Foster Homes
Provider7/2/2015Fee-for-service nursing facility rate changes effective July 1, 2015Hospice providers
Provider6/26/2015June 2015 reprocessing of some fee-for-service physician-administered drug claims340B Drug Program providers, Ambulatory surgical centers, Family planning clinics, Federally Qualified Health Centers, Hospital, Medical-surgical providers, Rural health clinics, Tribal health centers
Provider6/26/2015Fee-for-service professional claim reprocessing scheduled for June 27, 2015Medical-surgical providers
Provider6/22/2015Dental examinations under the OHP Recommended Periodicity ScheduleDental providers
Provider6/19/2015Provider Matters - June 2015All Providers
Plan, Provider6/12/2015OHP and ICD-10 readinessAll Providers, All plans
Public notice6/4/2015Extend OHA Hospital Transformation Performance Program through June 30, 2017 - Comments due July 15, 2015All interested parties
Provider5/29/2015Join us June 18 for Provider Collaborative - Pharmacy Business Processes and Claims BillingAll Providers
Provider5/22/2015Change to fee-for-service colonoscopy reimbursement effective June 1, 2015Medical-surgical providers
Provider5/19/2015Provider Matters - May 2015All Providers
Provider5/13/2015Codes that will require fee-for-service prior authorization starting July 1, 2015Medical-surgical providers
Provider4/22/2015Provider Matters - April 2015All Providers
Provider4/6/2015HPE Data Request and UpdatesHPE determination sites
Provider3/27/2015Fee-for-service professional claim reprocessing scheduled for March 28, 2015Medical-surgical providers
Provider3/26/2015Hospital Presumptive Eligibility updates and remindersHPE determination sites
Provider3/23/2015Provider Matters - March 2015All Providers
Provider3/5/2015Code A0434 re-opened for fee-for-service payment effective July 1, 2013Ambulance providers
Provider2/20/2015Provider Matters - February 2015All Providers
Provider1/28/2015January 30 2015 webinar - Provider Options to Verify Atypical OHP EligibilityAll Providers
Provider1/16/2015Provider Matters - January 2015All Providers
Provider1/15/2015Fee-for-service billing for drugs of abuse testing codes effective Jan. 1, 2015Clinical labs
Provider1/15/2015Fee-for-service RVU-weight-based rates effective January 1, 2015Medical-surgical providers
Provider1/12/2015Oregon Health Plan covers Applied Behavior Analysis services effective January 1, 2015Affected Providers, CCOs, Community Mental Health Programs
Plan, Provider1/12/20152014-2015 Prioritized List of Health Services effective January 1, 2015All Providers, CCOs
Provider12/24/2014Fee-for-service professional claim reprocessing scheduled for December 27, 2014Medical-surgical providers, Vaccines for Children Providers
Provider12/19/2014Accepted 2015 code sets for Radiation Oncology and Lower GI Endoscopy servicesAmbulatory surgical centers, Medical-surgical providers, CCOs
Public notice12/17/2014Extend OHA Tribal Uncompensated Care Program through June 30, 2017 - Comments due 1-17-2015All interested parties
Provider12/16/2014Outpatient billing for hospital dentistry claims effective January 1, 2015Hospital
Provider12/4/2014Level of Service Inventory required for AFH Plan of Care Authorizations starting January 1, 2015Community Mental Health Programs, AMH-Licensed Adult Foster Homes
Public notice12/1/2014Update description of new adult Medicaid population to align with OHP Plus benefit package - Comments due December 31, 2014All interested parties
Public notice12/1/2014Make Oregon's CCare program part of Oregon's Medicaid State Plan - Comments due December 31, 2014All interested parties
Provider11/28/2014Provider Matters - November 2014All Providers
Provider11/18/2014Federal primary care rate increase ending December 31, 2014Nurse practitioners, Physician assistants, Physicians
Provider11/14/2014Filling prescriptions for Oregon Medicaid clients who are not in the Oregon MMIS Point of Sale systemPharmacies
Provider11/14/2014Eligibility verification for HealthCare.gov OHP applicants effective November 15, 2014All Providers
Provider11/10/2014How to submit inmate Medicaid applications effective November 15, 2014Correctional facilities
Provider11/10/2014No changes to HPE process due to federal Health Insurance MarketplaceHPE determination sites
Provider10/29/2014Prior authorization and billing requirements for rehabilitative mental health services provided in AMH-licensed settingsAMH-licensed residential treatment providers, Community Mental Health Programs
Provider10/24/2014Provider Matters - October 2014All Providers
Provider10/23/2014October 2014 PDL and prior authorization criteria updatesPharmacies, Prescibing providers
Plan, Provider10/16/2014Encounter reporting of 340B-eligible drugs dispensed to Oregon Health Plan (OHP) clients340B Drug Program providers, Pharmacies, FCHPs, PCO, CCOs
Provider10/8/2014Change in DMAP provider call center hours effective October 20, 2014All Providers
Plan, Provider10/1/2014Providing enteral nutrition services for children with Oregon Health Plan benefitsEnteral nutrition companies, Hospital discharge planners, CCOs
Provider9/26/2014Provider Matters - September 2014All Providers
Plan, Provider9/25/2014Interim modifications to the Prioritized List of Health Services effective October 1, 2014All Providers, All plans
Provider9/24/2014Fee-for-service hospice rates effective October 1, 2014Hospice providers
Provider9/24/2014Fee-for-service home health rates effective January 1, 2015Home health providers
Provider9/17/2014August-September 2014 PDL and prior authorization criteria updatesPharmacies, Prescibing providers
Provider9/12/2014Reminders about billing for services to Qualified Medicare Beneficiaries (QMBs)All Providers
Provider9/12/2014Changes to paper claim mailing addresses effective October 1, 2014All Providers
Provider9/4/2014Location change for September 16 BRS Review Committee meetingBehavior Rehabilitation Services providers
Provider8/20/2014Clarifications about BRS Review Committee membershipBehavior Rehabilitation Services providers
Provider8/15/2014Provider Matters - August 2014All Providers
Provider7/18/2014Provider Matters - July 2014All Providers
Provider7/16/2014Preferred Drug List and prior authorization criteria updates effective July 15, 2014Pharmacies, Prescibing providers
Provider7/7/2014Fee-for-service reprocessing of substance use disorder claims planned for July 18, 2014Substance use disorder treatment providers, Community Mental Health Programs
Provider6/26/2014Fee-for-service reprocessing of 4th Quarter 2012 outpatient claims planned for June 27, 2014Oregon DRG hospitals
Provider6/23/2014Provider Matters - June 2014All Providers
Public notice6/23/2014Request for comment - Oregon's Medicaid 1915(c) Medically Involved Children's Waiver - Responses due July 23, 2014All interested parties
Provider6/20/2014Nursing facility rate changes effective July 1, 2014Hospice providers
Provider6/18/2014Third-trimester exemptions from coordinated care organization (CCO) enrollment will continue on and after July 1, 2014Maternal health care providers
Provider6/17/2014New Medicaid eligibility process for county jail inmatesCorrectional facilities
Provider6/17/2014Fee-for-service reprocessing of 3rd Quarter 2012 outpatient claims planned for June 20, 2014Oregon DRG hospitals
Provider6/5/2014Fee-for-service reprocessing of 2012 outpatient claims to resume June 6, 2014Oregon DRG hospitals
Provider5/30/2014Changes in non-emergency transportation contacts effective July 1, 2014Affected Providers, Ambulance providers, Home care workers, Hospital, Living settings
Plan5/23/2014DMAP reimbursement for procedure code T1015FCHPs, PCO, CCOs
Provider5/23/2014Provider Matters - May 2014All Providers
Provider5/23/2014Information about Hospital Presumptive Eligibility (HPE) for OHP pharmaciesHPE determination sites, Pharmacies
Plan, Provider5/21/2014Fee-for-service payment for code 90460 closed May 7, 2014Billing providers (billing services, clinics, clearinghouses), Federally Qualified Health Centers, Rural health clinics, Tribal health centers, FCHPs, PCO, CCOs
Provider5/19/2014Clarification about fee-for-service rate increase for procedure code T1015Family planning clinics
Provider5/13/2014Fee-for-service rate increase for procedure code T1015 effective June 1, 2014Family planning clinics
Provider5/13/2014Changes to billable fee-for-service laboratory codes effective June 1, 2014Billing providers (billing services, clinics, clearinghouses), Clinical labs, Hospital, Ordering providers
Provider4/25/2014Hospital Presumptive Eligibility (HPE) and Incarcerated IndividualsHPE determination sites
Provider4/24/2014New Hospital Presumptive Eligibility process effective January 1, 2014All Providers, HPE determination sites
Provider4/22/2014Status of fee-for-service reprocessing of 2012 outpatient claimsOregon DRG hospitals
Provider4/18/2014Fee-for-service reprocessing of HK claims planned for April 25, 2014Community Mental Health Programs, AMH-Licensed Residential and Outpatient Providers
Provider4/18/2014Provider Matters - April 2014All Providers
Provider3/28/2014March 21, 2014 Preferred Drug List (PDL) and PA Criteria updatesPharmacies, Prescibing providers
Provider3/25/2014Provider Matters - March 2014All Providers
Plan, Provider3/20/2014Interim modifications to the Prioritized List of Health Services effective April 1, 2014All Providers, All plans
Member3/6/2014Changes for OHP medical transportation clients and Cascade East Ride CenterAll interested parties, Affected Providers, Transportation providers, Affected members
Provider2/28/2014Provider Matters - February 2014All Providers
Plan, Provider2/25/20142014-2015 Prioritized List of Health Services to become effective October 1, 2014All Providers, All plans
Provider1/17/2014Fee-for-service reprocessing of 2012 outpatient claims to resume January 17, 2014Oregon DRG hospitals
Provider1/17/2014Provider Matters - January 2014All Providers
Public notice1/14/2014Amend DME fee schedule to a percentage of 2012 Medicare Fee Schedule - Comments due February 7, 2014All interested parties
Provider1/13/2014Fee-for-service Preferred Drug List update effective January 10, 2014Pharmacies, Prescibing providers
Provider1/3/2014Fee-for-service Preferred Drug List and prior authorization criteria updates effective January 1, 2014Pharmacies, Prescibing providers
Provider1/3/2014Fee-for-service reprocessing of some dental claims scheduled for January 10, 2014Dental providers
Provider12/24/2013Provider Matters - December 2013All Providers
Provider12/20/2013Fee-for-service RVU-weight-based rates effective January 1, 2014Medical-surgical providers
Public notice12/16/2013Proposal to reimburse certain primary care physicians using site of service adjustments - Responses due 1-15-2014All interested parties
Provider12/11/2013Fee-for-service reprocessing of some extended care claimsNursing facilities
Provider12/11/2013Fee-for-service reprocessing of some anesthesia claimsAnesthesia provider, Billing providers (billing services, clinics, clearinghouses)
Provider11/21/2013Provider Matters - November 2013All Providers
Provider11/7/2013New process and form for Inpatient Hospital Requests for OHP ApplicationsHospital
Provider11/7/2013Medicaid Provider Enrollment Process for Behavior Rehabilitation Services ProvidersBehavior Rehabilitation Services providers
Provider11/7/2013New form – OHP Client Agreement to Pay for Health Services, DMAP 3165All Providers
Provider10/31/2013Fee-for-service reprocessing of 2012 outpatient DRG claims to begin November 8, 2013Oregon DRG hospitals
Provider10/24/2013Place of service to determine fee-for-service RVU-based payments starting January 1, 2014Ambulatory surgical centers, Billing providers (billing services, clinics, clearinghouses), Hospital
Provider10/21/2013Provider Matters - October 2013All Providers
Plan, Provider9/30/2013Interim modifications to the Prioritized List of Health Services effective October 1, 2013All Providers, All plans
Provider9/26/2013Fee-for-service rate change for surgical assists, effective October 1, 2013Medical-surgical providers
Provider9/26/2013Provider Matters - September 2013All Providers
Provider9/26/2013Fee-for-service hospice rates effective October 1, 2013Hospice providers
Provider9/17/2013CAWEM Plus prenatal benefit expands to all Oregon counties effective October 1, 2013All Providers
Member9/17/2013CAWEM Plus benefits will be available in all Oregon counties beginning October 1, 2013Affected members
Provider8/30/2013Primary Care Management contracts end September 30, 2013Primary Care Managers
Member8/30/2013Open card members moving to CCO October 1Affected members
Public notice8/28/2013Oregon Medicaid Alternative Benefit Plans under the Affordable Care Act - Responses due 9-30-2013All interested parties
Provider8/16/2013Provider Matters - August 2013All Providers
Provider8/1/2013County Behavior Rehabilitation Service rate changes effective August 1 to December 31, 2013Behavior Rehabilitation Services providers
Provider7/30/2013Changes to fee-for-service inpatient claim processing for Health Care-Acquired Conditions starting September 1, 2013Type A/B Critical Access Hospitals
Provider7/19/2013Provider Matters - July 2013All Providers
Provider7/3/20132013-2014 Federal Primary Care Rate UpdatePhysicians, nurse practitioners and physician assistants practicing General Internal Medicine, Pediatric Medicine, or Family Medicine
Provider6/26/2013Hospice-nursing facility rate changes effective July 1, 2013Hospice providers, Nursing facilities
Provider6/21/2013Provider Matters - June 2013All Providers
Provider6/20/2013July 1, 2013 authorization changes to non-emergency ambulance transportationAmbulance providers, Hospital, Nursing facilities, Living settings and facilities that arrange for non-emergency ambulance transports
Member6/20/2013Change in prior authorization and reimbursement contact for travel expensesMembers with OHP Plus (BMM, BMD, BMH) or CWX benefits
Provider6/7/2013Fee-for-service home health rates effective July 1, 2013Home health providers
Provider5/17/2013Switching to electronic rate change notifications - Subscribe todayHospice providers
Provider5/17/2013Provider Matters - May 2013All Providers
Provider5/17/2013Switching to electronic rate change notifications – Subscribe todayHospice providers
Provider4/29/2013Preferred Drug List and PA criteria updates effective May 1, 2013Pharmacies, Prescibing providers
Plan, Provider4/18/2013Implementation status and updated training for hospice in nursing facility payment processHospice providers, Nursing facilities, All plans
Provider4/18/2013Provider Matters - April 2013All Providers
Provider4/18/2013Updates about the 2013-2014 primary care rate increaseNurse practitioners, Physician assistants, Physicians
Provider4/8/2013340B drugs at acquisition cost for all OHP members340B Drug Program providers
Provider3/29/2013Retraction of Interim modification to HERC Prioritized List Guideline 85 effective April 1, 2013All Providers
Provider3/28/2013Provider Matters - March 2013All Providers
Provider3/27/2013Medicare Grouper Version 30 mass adjustment on April 12, 2013Hospital
Provider3/20/2013Fee-for-service Relative-Value Unit weight-based rates effective January 1, 2013Medical-surgical providers
Provider3/20/2013Spring 2013 Provider Training and Resource UpdatesAll Providers
Plan, Provider3/15/2013Interim modifications to the Prioritized List of Health Services effective April 1, 2013All Providers, All plans
Provider2/15/2013Provider Matters - February 2013All Providers
Provider2/14/2013Attestation form now available – Attest to meeting CMS’s new primary care provider definitionNurse practitioners, Physician assistants, Physicians
Provider2/14/2013Reminders about verifying client eligibility, enrollment status and benefitsAll Providers
Provider1/31/2013Include the Rendering Provider’s ID on Oregon Medicaid claimsAMH-Certified Community Mental Health Programs and AMH-Approved Chemical Dependency Treatment Providers
Provider1/25/2013Clarification about how new CMS definition of primary care affects Oregon primary care providersNurse practitioners, Physician assistants, Physicians
Provider1/22/2013Reduce paper claims by using the Provider Web PortalProviders who bill DMAP fewer than 50 claims a month
Provider1/17/2013Ambulatory Payment Classification (APC) methodology to be implemented Jan. 22, 2013Oregon DRG hospitals
Provider1/17/2013Provider Matters - January 2013All Providers
Provider1/9/2013Clarifying issues with hospice and nursing facility contracts, and client optionsHospice providers, Nursing facilities
Plan1/4/2013Changes to primary care provider definition and primary care rates effective Jan. 1, 2013FCHPs, PCO, CCOs, MHOs
Provider12/21/2012Preferred Drug List (PDL) and prior authorization criteria updates effective Jan. 1, 2013Pharmacies, Prescibing providers
Provider12/21/2012Winter 2013 Provider Training and Resource UpdatesAll Providers
Provider12/21/2012OHP provider training and resources - Updated with training video and EDMS Coversheet informationAll Providers
Provider12/21/2012Delay in payment process change for nursing facility residents receiving hospiceHospice providers, Nursing facilities, All plans
Provider12/19/2012Dec. 31 and Jan. 1 Point of Sale billing changesPharmacies
Provider12/16/2012Provider Matters - December 2012All Providers
Plan, Provider11/27/2012Patient-Centered Primary Care Home - Medicaid payment updates (letter emailed Nov. 21)Patient-Centered Primary Care Homes and plans
Plan, Provider11/20/2012Reminder - Attend Nov. 28 and 29 training about billing process for nursing facility residents who elect hospiceHospice providers, Nursing facilities, All plans
Provider11/16/2012Provider Matters - November 2012All Providers
Provider11/14/2012More Revenue Codes will require HCPCS reportingOregon DRG hospitals
Public notice11/14/2012Proposal to increase primary care reimbursement and VCF rates - Responses due 12-17-2012All interested parties
Provider11/6/2012Primary Care Manager clients will be disenrolled Nov. 1, 2012 (mailed Oct. 10)Primary Care Managers
Provider11/6/2012Reminders about billing for ambulance servicesAmbulance providers
Provider11/6/2012Updated Coordinated Care Organization Pharmacy Benefit Manager ListPharmacies
Provider11/2/2012Payment process change for nursing facility residents receiving hospice, effective Jan. 1, 2013Hospice providers, Nursing facilities
Provider10/29/2012Wave 4 Coordinated Care Organization (CCO) transition updatePharmacies
Provider10/29/2012Oregon Pharmacy Call Center closed due to Hurricane Sandy; please leave voicemails at 1-888-202-2126 for same-day responsePharmacies, Prescibing providers
Provider10/18/2012New rate for Babies First! and CaCoon Targeted Case Management services effective September 2, 2012Babies First! and CaCoon TCM providers
Provider10/17/2012Rebill DMAP for maternity case management claims that incorrectly denied due to CCO enrollmentMaternity case managers
Provider10/16/2012Palivizumab (Synagis) reimbursement remindersMedical practitioners
Provider10/16/2012Provider Matters - October 2012All Providers
Provider10/12/2012Join us for OHA's Two-Day ICD-10 Conference, Oct. 29-30All Providers
Provider10/10/2012Medicare Grouper Version 30 DelayedHospital
Provider10/8/2012Billing for services under codes E1399 and K0108Durable Medical Equipment (DME) providers
Provider9/28/2012Fee-for-service hospice rates effective Oct. 1, 2012Hospice providers
Member9/25/2012Open card members moving to CCO Nov. 1 - Multiple CCO choiceAffected members
Member9/25/2012Open card members moving to CCO Nov. 1 - One CCO choiceAffected members
Provider9/24/2012Consider direct depositProviders who still receive paper checks from DMAP
Provider9/24/2012Bill DMAP electronically for faster claim processing and lower denial ratesProviders who bill DMAP using paper claim forms
Plan, Provider9/24/2012Prioritized List changes effective Oct. 1, 2012All Providers, All plans
Provider9/21/2012Fall 2012 Provider Training and Resource UpdatesAll Providers
Provider9/21/2012Training and resources for Oregon Health Plan providersAll Providers
Provider9/21/2012Provider Matters - September 2012All Providers
Member9/20/2012Oct. 1 coordinated care organization (CCO) enrollment noticeJefferson Behavioral Health plan members in Curry County
Member9/20/2012Tillamook County FFS-MHO enrolled members moving to Columbia Pacific CCO Oct. 1Affected members in Tillamook County
Member9/16/2012Sherman County PacificSource members moving to EOCCO October 1, 2012Sherman County PacificSource members
Provider9/13/2012Preferred Drug List and prior authorization criteria updates effective September 24, 2012Pharmacies, Prescibing providers
Provider9/10/2012Rate reductions for ambulance services effective Sep. 1, 2012 (e-mailed to affected providers Aug. 27)Transportation providers
Provider9/10/2012Rate reductions for anesthesia and RVU-based professional services effective Sep. 1, 2012 (mailed Aug. 27)Medical-surgical providers
Plan, Provider8/31/2012CMS Update - ICD-10 compliance date is now Oct. 1, 2014All Providers, All plans
Provider8/22/2012Brand GEODON® and LEXAPRO® to be removed from the OHP Preferred Drug ListPharmacies, Prescibing providers
Provider8/20/2012Delay in use of APC methodology software for DRG hospital outpatient claimsOregon DRG hospitals
Provider8/16/2012Provider Matters - August 2012All Providers
Provider8/8/2012Oregon DRG Hospitals - Changes to outpatient claims processing effective Aug. 21, 2012Oregon DRG hospitals
Provider8/1/2012Please call the Oregon Pharmacy Call Center for help filling any Oregon Health Plan prescriptions during CCO transitionPharmacies
Member8/1/2012September 1 Coordinated Care Organization (CCO) enrollment noticeAffected members
Public notice7/27/2012Proposal to update Babies First! and CaCoon TCM rates - Responses due 9-30-2012All interested parties
Plan, Provider7/26/2012Correction to information about ICD-10 complianceAll Providers, All plans
Provider7/20/2012Provider Matters - July 2012All Providers
Provider7/18/2012Preferred Drug List and PA criteria updates effective July 23, 2012Pharmacies, Prescibing providers
Provider7/12/2012Lipitor® no longer on OHP preferred drug listPharmacies, Prescibing providers
Provider7/10/2012Free Provider Training - Summer 2012 ReminderAll Providers
Provider7/10/2012Join OHA for a Coordinated Care Organizations Webinar on July 17All Providers
Member6/29/2012August 1 coordinated care organization (CCO) enrollment noticeFCHP members in Curry, Josephine, Jackson, Clackamas, Multnomah, Washington, Marion, Polk, Benton, Linn, Lincoln, Deschutes, Crook, Jefferson, Klamath, Lane, Douglas, Coos and Curry counties
Provider6/28/2012Hospital Services Program changes effective July 1, 2012Hospital, Medical-surgical providers
Provider6/27/2012Cost report and billing information for Babies First! and CaCoon Targeted Case Management ratesBabies First! and CaCoon TCM providers
Provider6/22/2012340B Providers - Rebill for family planning NDCs340B Drug Program providers
Provider6/18/2012Request for most recent Medicare Cost ReportsHome health agencies
Provider6/15/2012Preferred Drug List and PA criteria updates effective June 21, 2012Pharmacies, Prescibing providers
Provider6/15/2012Provider Matters - June 2012All Providers
Plan6/15/2012NCPDP Carve-Out Drug Files available July 3, 2012FCHPs, PCO, MHOs
EDI Submitter6/7/2012HIPAA 5010 compliance required by Friday, June 29Electronic Data Interchange (EDI) trading partners
Provider6/1/2012July 2012 rate reductions for non-CCO providersAll Providers
Provider5/18/2012Provider Matters - May 2012All Providers
Provider5/14/2012May 14, 2012 PDL and prior authorization criteria updatesPharmacies, Prescibing providers
Provider5/8/2012Zyprexa® no longer preferred over generic equivalents starting May 16Pharmacies, Prescibing providers
Public notice5/4/2012Proposal to reimburse Seattle Children's Hospital for outlier payments - Responses due 6-30-2012All interested parties
Provider4/24/2012Changes to LEXAPRO®, ZYPREXA® and GEODON® until further noticePharmacies, Prescibing providers
Provider4/16/2012Free Provider Training - Spring 2012 ReminderAll Providers
Provider3/28/2012Umatilla County adds CAWEM Plus Prenatal servicesAll Providers
EDI Submitter3/27/20125010 deadline extended to June 29Electronic Data Interchange (EDI) trading partners
Member3/27/2012CAWEM Prenatal benefits in Umatilla County starting April 1, 2012CAWEM-eligible pregnant women living in Umatilla County
Plan, Provider3/21/2012Status of Jan. 1 changes to payment methodology for DRG hospitalsOregon DRG hospitals, FCHPs, PCO, CCOs
Plan, Provider3/20/2012Prioritized List changes effective Apr. 1, 2012All Providers, All plans
Provider3/16/2012Provider Matters - March 2012All Providers
Plan3/7/2012New 834 maintenance reason codes due to Senate Bill 201 implementationFCHPs, PCO, DCOs
EDI Submitter3/2/2012Complete 5010 registration and testing by Friday, Mar. 30Electronic Data Interchange (EDI) trading partners
Plan, Provider3/1/2012Updated data to determine non-participating DRG hospital reimbursementOregon DRG hospitals, FCHPs
Public notice2/22/2012DHS as an Organized Health Care Delivery SystemAll interested parties
Provider2/17/2012Provider Matters - February 2012All Providers
EDI Submitter2/16/20124010 submitters - Please complete 5010 registration by Mar. 1, 2012Electronic Data Interchange (EDI) trading partners
Provider2/13/2012Enrollment updates required for Expanded Practice Dental Hygienists effective January 1, 2012Expanded Practice (formerly Limited Access Practice) Dental Hygienists
EDI Submitter2/7/2012Action required if you need to exchange 4010 transactions with DMAP after Mar. 1, 2012All Providers
EDI Submitter2/7/2012EDI Bulletin - 5010 status and remindersElectronic Data Interchange (EDI) trading partners
Provider1/27/2012Provider Matters - January 2012All Providers
Provider1/26/2012Feb. 4 reprocessing planned for DMEPOS claimsDurable Medical Equipment (DME) providers
Provider1/13/2012Leverage account reconciliation planned for February 2012Behavior Rehabilitation Services providers, School-Based Health Services providers, Targeted Case Management providers
Provider1/13/2012Fee-for-service Relative Value Unit (RVU) rates staying the same for Jan. 1, 2012Medical-surgical providers
Provider1/13/2012How to adjust point of sale claims submitted before Jan. 1, 2012Pharmacies
EDI Submitter1/12/2012EDI Bulletin - 270 Search CriteriaElectronic Data Interchange (EDI) trading partners
Provider1/10/2012Apply for 2011 Medicaid EHR Incentives by Feb. 29, 2012Medical practitioners, Clinics and health care centers
Provider1/9/2012Rule revisions for multiple programs effective January 1, 2012All Providers
Provider1/5/2012Free provider training opportunities - Winter 2012All Providers
Provider1/5/2012Fee-for-service home health rates effective Jan. 1, 2012Home health providers
Provider12/27/2011LOVENOX® added to OHP’s Preferred Drug List, effective January 1, 2012Pharmacies, Prescibing providers
EDI Submitter12/27/2011EDI Bulletin – 5010 special releaseEDI submitters
Provider12/27/2011Provider Web Portal unavailable for four hours between Dec. 31 and Jan. 1Provider Web Portal users
Provider12/20/2011Pharmaceutical Services Program changes effective January 1, 2012Pharmacies, Prescibing providers
Provider12/20/2011Provider Matters - December 2011All Providers
EDI Submitter12/20/2011EDI Bulletin - Prepare for Jan. 1 changesElectronic Data Interchange (EDI) trading partners
Member12/19/2011Benefit reductions for all clients and coverage expansion for OHP Standard clientsAll members
Provider12/19/2011January 2012 benefit changes for allAll Providers
Provider12/13/2011Get ready for system changes effective January 1, 2012All Providers
Provider12/13/2011Have your practitioners apply for 2011 Medicaid EHR incentives by Feb. 29, 2012Federally Qualified Health Centers, Rural health clinics, Tribal health centers
Plan12/9/2011Social Security Number and Date of Birth Required for Newly Enrolling Providers or SuppliersAll plans
Provider12/6/2011DMAP will only accept NCPDP D.0 Point of Sale claims beginning Jan. 1, 2012Pharmacies
Plan, Provider11/30/2011DMAP Implementation of Senate Bill 101Federally Qualified Health Centers, All plans
Provider11/23/2011Provider Matters - November 2011All Providers
Provider11/21/20112012-2013 Prioritized List of Health Services now availableAll Providers, All plans
Provider11/9/2011Nov. 15 OHP Plus adult dental changes postponedDental providers
Provider11/9/2011Join OHA for November phone forums about Medicaid EHR IncentivesDental providers, Medical practitioners, Nurse practitioners, Physician assistants, Physicians
Provider10/25/2011Learn how your practitioners can apply for Medicaid EHR incentivesFederally Qualified Health Centers, Rural health clinics, Tribal health centers
Provider10/25/2011OHP Plus dental coverage changes planned for Nov. 15, 2011Dental providers
Provider10/25/2011Join OHA's Medicaid EHR Incentive Program phone forum for eligible professionalsDental providers, Nurse practitioners, Physician assistants, Physicians
Provider10/21/2011Provider Matters - October 2011All Providers
EDI Submitter10/12/2011EDI Bulletin - October 2011Electronic Data Interchange (EDI) trading partners
Provider10/7/2011Fee-for-service hospice rates effective October 1, 2011Hospice providers
Provider9/30/2011Provider Matters - September 2011All Providers
Provider9/30/2011Pharmacy, AI-AN, FQHC-RHC, General Rules and OHP program changes effective Oct. 1, 2011All Providers
Provider9/27/2011Please submit 2009 Medicare Cost Reports by Oct. 15, 2011Home health providers
Plan, Provider9/15/2011Interim Modifications to the Prioritized List of Health Services effective October 1, 2011All Providers, All plans
Provider9/14/20112011-2013 mandatory state office closuresAll Providers
Provider9/1/2011Pharmaceutical Services rule revisions effective September 1, 2011Pharmacies
Provider8/31/2011Client access to medical equipment and suppliesOrdering providers (e.g., hospital discharge planners and adult foster homes)
Provider8/31/2011Free provider training opportunities - Fall 2011All Providers
Provider8/31/2011Provider Matters - August 2011All Providers
Provider8/22/2011Usual and Customary charge definition revised, effective September 1, 2011Pharmacies
Provider8/17/2011Get ready for electronic data interchange and pharmacy point of sale changesAll Providers
Provider8/15/2011Free Provider Training - Summer 2011 ReminderAll Providers
Provider8/9/2011Clarification about DMEPOS fee-for-service rate reduction effective August 1, 2011Durable Medical Equipment (DME) providers
Provider8/3/2011Fee-for-service rate reductions effective August 1, 2011 (all programs)Billing providers (billing services, clinics, clearinghouses)
Provider8/3/2011Change to revenue codes that require CPT, HCPCS and NDC reporting effective July 1, 2011Hospital, Medical practitioners
Provider7/29/2011Provider Matters - July 2011All Providers
Provider7/29/2011Aug. 1 Diabetic Supply Billing UpdatesDurable Medical Equipment (DME) providers, Pharmacies
Provider7/29/2011Administrative rule revisions effective August 1, 2011All Providers
Provider7/28/2011Fee-for-service rate reduction for anesthesia services effective August 1, 2011Anesthesia provider
Public notice7/27/2011Increase the state’s current hospital tax and increase Oregon Medicaid reimbursement to hospitalsAll interested parties
Provider7/25/2011Rate reductions for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) effective Aug. 1, 2011Durable Medical Equipment (DME) providers
Provider7/22/2011July 2011 administrative rule revisionsAll Providers
Provider7/21/2011Correction to fee-for-service Alcohol and Drug rate reductions effective August 1, 2011Outpatient alcohol and drug treatment providers
Provider7/18/2011Fee-for-service rate reduction information for mental health services effective August 1, 2011Mental health providers
Provider7/18/2011Bill diabetic supplies in pharmacy claim format starting August 1, 2011Durable Medical Equipment (DME) providers, Pharmacies
Provider7/14/2011Fee-for-service rate reductions for ambulance services effective August 1, 2011Ambulance providers
Provider7/13/2011Fee-for-service rate reductions for medical-surgical services effective August 1, 2011Clinical labs, Maternity case managers, Medical practitioners
Provider7/12/2011Fee-for-service rate reduction for outpatient alcohol and drug treatment services effective August 1, 2011Outpatient alcohol and drug treatment providers
Provider7/12/2011Fee-for-service rate reduction for home health services effective August 1, 2011Home health providers
Provider7/12/2011Adjustments for HFA inhaler overpayments now scheduled for July 23 weekendPharmacies
Provider7/11/2011Fee-for-service rate reduction for dental services effective August 1, 2011Dental providers
Provider7/8/2011Fee-for-service rate reduction for pharmacy services effective August 1, 2011Pharmacies
Provider7/1/2011Administrative rule revisions effective July 1, 2011All Providers
Public notice6/30/2011New procedures for exceeding DSH payment limits for State Plan Rate Years 2005 and forwardAll interested parties
Provider6/29/2011Expanded coverage of LAP dental hygienist services effective July 1, 2011Expanded Practice (formerly Limited Access Practice) Dental Hygienists
Provider6/28/2011Find out if you are eligible for Medicare and Medicaid Electronic Health Record Incentive ProgramsHospital, Medical practitioners
Provider6/27/2011NDC reporting for physician-administered drugs required starting July 1, 2011Hospital, Medical practitioners
Provider6/24/2011Provider Matters - June 2011All Providers
Provider6/20/2011Pharmacies can bill for diabetic supplies starting August 1, 2011Pharmacies
Provider6/20/2011Bill diabetic supplies in pharmacy claim format starting Aug. 1, 2011Durable Medical Equipment (DME) providers
Provider6/17/2011Submit claims by noon Friday to ensure weekend claim processingNon-pharmacy providers
EDI Submitter6/17/2011EDI Bulletin - 5010 and NCPCP D.0 readinessElectronic Data Interchange (EDI) trading partners
Provider6/15/2011System mass adjustments planned for overpayments of certain inhalersPharmacies
Provider5/27/2011Provider Matters - May 2011All Providers
Plan5/16/2011Update on CAREAssist client disenrollment projectFCHPs
Provider5/13/2011NCPDP D.0 claims submission changes and transition testingPharmacies
Plan, Provider4/27/2011Review new resources about NDC reportingAll Providers, FCHPs, PCO
Provider4/22/2011Provider Matters - April 2011All Providers
Provider4/21/2011Compounded 17aHPC is only covered as physician-administered drugPharmacies, Prescibing providers
Provider3/30/2011Provider Matters - March 2011All Providers
Provider3/30/2011DMEPOS, OHP and Speech-Hearing rule changes effective March 25 and April 1, 2011All Providers
Provider3/25/2011Coverage for certain compounding ingredients ends April 1, 2011Pharmacies
Provider3/22/2011DMAP moves to the Oregon Health Authority effective July 1, 2011All Providers
EDI Submitter3/21/2011EDI Bulletin 24Electronic Data Interchange (EDI) trading partners
Provider3/16/2011National Correct Coding Initiative edits planned for April 1, 2011Ambulatory surgical centers, Hospital, Medical practitioners
Provider3/10/2011Medicaid federal and local match rate changes for January-June 2011Behavior Rehabilitation Services providers, School-Based Health Services providers, Targeted Case Management providers
Plan, Provider2/28/2011Interim modifications to the Prioritized List of Health Services effective April 1, 2011All Providers, All plans
Provider2/28/2011Provider Matters - February 2011All Providers
Provider2/24/2011New Third-Party Liability edit and NCPDP D.0 updatePharmacies
Provider2/24/2011Certain products removed from Preferred Drug List effective March 1, 2011Pharmacies, Prescibing providers
Provider2/15/2011Use November 2010 Newborn Notification form to report OHP newbornsBirthing centers, Hospital, Midwives
Plan, Provider2/10/2011New process for provider administrative reviewsAll Providers, All plans
Provider2/4/2011Claims error corrected for certain revenue codesHome health providers, Hospice providers
Provider1/21/2011Provider Matters January 2011All Providers
Provider1/11/2011CPT consultation codes 99241-99255 closed for payment effective Jan. 1, 2011Medical practitioners
Provider1/5/2011DMAP now uses Average Actual Acquisition Cost ReimbursementPharmacies
Plan12/27/2010NDC reporting requirements effective Jan. 1, 2011All plans
Provider12/10/2010Third Party Liability billing and Oregon MedicaidBehavior Rehabilitation Services providers
Public notice12/9/2010DMAP to reimburse pharmacies at Wholesale Acquisition Cost when no Actual Acquisition Cost is availableAll interested parties
Plan11/17/2010Preparation for Jan. 1 managed care copayment requirementAll plans
Plan10/27/2010Delay in encounter-only provider enrollment requestsAll plans
Plan10/26/2010Follow-up to Oct. 6 Critical Incident CommunicationsFCHPs, PCO, DCOs, MHOs
Plan6/25/2010Vaccines for Children Program - Clarification of MCO requirementsFCHPs, PCO, DCOs, MHOs
Plan6/23/2010Correction to managed care enrollment history segmentsAll plans
Public notice5/20/2010Proposal to remove Tuberculosis TCM program from State PlanAll interested parties
Public notice1/13/2010Extend the alternate payment methodology for delivery procedures to rural health clinicsAll interested parties