MedicaidReimbursementMedium impact
Fee-for-service reprocessing for certain Home and Community-Based Services claims starting March 3, 2023
Oregon Health Plan·OR · Psychiatry, Family Medicine, Pediatrics·Provider
Effective date
Mar 3, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is reprocessing certain Medicaid Home and Community-Based Services claims from April 2021 through March 2022 to secure increased federal funding under the American Rescue Plan. Providers may receive additional payments where reprocessing results in higher reimbursement, while some local match funds will be returned for SBHS and TCM claims.
Action Required
Immediately: Billing team should review remittance advices for reprocessed HCBS claims from April 2021-March 2022 period. Monitor for additional payments or local match fund returns. Contact Provider Services at 800-336-6016 if discrepancies are found in reprocessed payments.