MedicaidCoverageMedium impact
Updates to Medicaid Post-Hospital Extended Care Benefit, effective Jan. 1, 2026
Oregon Health Plan·OR · PM&R (Physical Medicine & Rehab)·Provider
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Oregon has expanded Medicaid Post-Hospital Extended Care (PHEC) benefit coverage from 20 to 100 days for qualifying OHP members who meet Medicare skilled nursing criteria but lack Medicare coverage. This applies to members with a minimum 3-day hospital stay who need extended care services.
Action Required
Immediately: Share PHEC policy update and Provider Guide with billing and discharge planning staff. Update workflows to reflect 100-day coverage period for qualifying OHP members. For eligibility assessment: contact local APD/AAA office for fee-for-service members or member's CCO for coordinated care organization members. Continue billing PHEC according to existing requirements.