MedicaidAdministrativeLow impact
Notice of Adverse Benefit Determination (NOABD) for Non-Emergent Medical Transportation (NEMT) Services Requirement Update
Oregon Health Plan·OR·Plan contract
Effective date
Oct 21, 2024
We identified it
Jun 20, 2026
Summary
Oregon Health Authority has waived the requirement to include primary care provider, dentist, or behavioral health professional names in Notice of Adverse Benefit Determination (NOABD) letters specifically for Non-Emergent Medical Transportation (NEMT) services denials. This simplifies the administrative burden for CCOs when issuing denial notices for transportation services.
Action Required
Immediately: Administrative staff processing NEMT service denials should update NOABD templates to remove the requirement for PCP/PCD/BH provider names. This change only applies to transportation service denials, not medical service denials. Updated templates will be available by October 31, 2024.