MedicaidAdministrativeHigh impact
PHE Authorities and Flexibilities on and after May 11, 2023
Oregon Health Plan·OR·Plan
Effective date
May 11, 2023
We identified it
Jun 20, 2026
Summary
Oregon's Public Health Emergency ended May 11, 2023, reinstating normal Medicaid operations including prior authorization requirements, ending enhanced reimbursement rates, and removing COVID-19 billing flexibilities. Multiple rate increases for behavioral health, nursing facilities, and developmental disability services ended June 30, 2023.
Action Required
Immediately: Billing teams must reinstate prior authorization requirements for all Medicaid fee-for-service claims that were previously suspended. By June 30, 2023: Update billing systems to remove 10% rate increases for behavioral health residential providers, nursing facilities, assisted living facilities, and 5% rate increases for developmental disability services. Revert COVID-19 diagnostic test reimbursement from 100% Medicare rate back to regular Oregon Medicaid fee schedule. Remove pharmacy flexibilities including waived day supply limits and automatic prior authorization renewals.