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MedicaidAdministrativeMedium impact

Encounter data for Health-Related Social Needs services

Oregon Health Plan·OR·Plan contract
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority is changing how Health-Related Social Needs (HRSN) services are reported by Coordinated Care Organizations (CCOs). Starting August 1, 2024, all HRSN services must be submitted through the Medical Management Information System (MMIS) as encounter data instead of the previous Settlement Template reporting method.

Action Required

Action needed
By August 1, 2024: Oregon CCO billing teams must transition HRSN services reporting from Settlement Template to MMIS encounter data submission system. Update billing workflows to ensure all HRSN services with dates of service August 1, 2024 and forward are submitted through MMIS only. Continue using Settlement Template only for HRSN services rendered March 1-July 31, 2024. Contact OHA's Office of Actuarial and Financial Analytics at Actuarial.Services@odhsoha.oregon.gov with questions.