MedicaidAdministrativeLow impact
Notices of Adverse Benefit Determination sample for January-March 2025
Oregon Health Plan·OR·Plan
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority has waived the requirement for Coordinated Care Organizations (CCOs) to submit samples of Notices of Adverse Benefit Determination and Prior Authorization documentation for Q1 2025 (January-March 2025). This administrative waiver does not affect other grievance and appeal system requirements.
Action Required
No action required for billing teams. This is an administrative waiver that affects CCO reporting requirements to the state, not provider billing or documentation obligations. All other grievance and appeal system requirements remain in effect.