MedicaidAdministrativeMedium impact
Update #2 regarding Planned Parenthood claims
Oregon Health Plan·OR · OB-GYN, Family Medicine·Plan
Effective date
Jul 22, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority issued updated guidance on processing Planned Parenthood claims due to federal legislation. CCOs must hold claims for most Medicaid members with dates of service July 22, 2025 and after, but can process claims for HOP members and non-Medicaid contracts normally.
Action Required
Immediately: Billing team must implement date-specific processing rules for Planned Parenthood claims. Hold all Planned Parenthood claims for CCO Medicaid Contract members with dates of service July 22, 2025 and after (except HOP members). Pay claims with dates July 8-21, 2025. Process HOP member claims and Non-Medicaid/OHP Bridge-BHP Contract claims normally regardless of date. Update billing system to flag these claims for manual review based on member contract type and service dates.