MedicaidAdministrativeMedium impact
Update #5 regarding Planned Parenthood claims
Oregon Health Plan·OR · OB-GYN·Plan contract
Effective date
Jul 4, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority Update #5 clarifies Planned Parenthood claim processing rules for CCOs based on court decision. Claims for July 4-September 10, 2025 should be processed normally, while claims from September 11, 2025 onward should be held for most Medicaid members (except HOP members).
Action Required
Immediately: Review all Planned Parenthood claims by date of service. Process claims for dates July 4-September 10, 2025 normally. Hold all Planned Parenthood claims for Medicaid Contract CCO members with dates of service September 11, 2025 or later, except for Healthier Oregon Program (HOP) members. Continue processing normally for Non-Medicaid and Oregon Health Plan Bridge members.