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Notice of intent: OHA will amend the Medicaid State Plan to renew the 1915(i) state plan option - Comments due May 29, 2026
Effective date
Jan 1, 2027
Identified
Jun 20, 2026
Summary
Oregon Health Authority will submit a State Plan Amendment to renew the 1915(i) Home and Community-Based Services state plan option, effective January 1, 2027. The 1915(i) HCBS state plan option must be renewed and approved every 5 years. The renewal has no significant changes to program eligibility, Community-Based Integrated Supports, Psychosocial Rehabilitation, In-Home Personal Care, Residential Habilitation, or reimbursement methodologies. Public comments were due by 5 p.m. Friday, May 29, 2026, and the estimated Total Fund 2027 cost is $146,609,320.
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What to do
Action · 9 steps
01Future effective date January 1, 2027: Billing team must confirm that 1915(i) HCBS services are billed under the renewed state plan option.
02All 1915(i) HCBS residential and In-Home Personal Care services require prior authorization before service delivery or payment.
03Providers must be enrolled as Medicaid providers and meet the provider qualifications for the service they provide.
04Existing codes for HCBS Residential Habilitation, Community-Based Integrated Supports and Psychosocial Rehabilitation are paired with modifier HW to identify them as State Plan HCBS services.
05Psychosocial Rehabilitation is billed with H2017 (15-minute) or H2018 (per diem).
06Providers record the time and dates of In-Home Personal Care services in the state's electronic visit verification system.
07Home delivered meals are limited to one per day and are not available in settings where residential providers are responsible for meals.
08Payment is not made for room and board costs.
09The comment deadline of May 29, 2026 has passed, so check the current status of this amendment before relying on this notice.
Codes mentioned
H2017H2018
Original notice
Notice of intent: OHA will amend the Medicaid State Plan to renew the 1915(i) state plan option - Comments due May 29, 2026
oregon.gov · Always check the source before changing claims.
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