MedicaidCoverageMedium impact
Oregon Health Plan (OHP) is primary payer for formulas and nutritional supplements covered by OHP and WIC, effective January 12, 2024.
Oregon Health Plan·OR · Pediatrics, Family Medicine, Internal Medicine·Plan
Effective date
Jan 12, 2024
We identified it
Jun 20, 2026
Summary
Effective January 12, 2024, Oregon Health Plan (OHP) became the primary payer for formulas and nutritional supplements when patients are enrolled in both OHP and WIC programs. Billing teams must bill OHP first instead of requiring WIC resources to be used first for these covered items.
Action Required
Immediately: Billing team must update policies and procedures to ensure OHP is billed as primary payer for formulas and nutritional supplements for dual OHP/WIC enrolled patients. Remove any requirement for WIC resources to be exhausted first. Share this information with clinical staff who process formula and nutrition supplement requests.