MedicaidPrior AuthMedium impact
Revision to Oregon Health Plan coverage of home testing for COVID-19
Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +1 more·Plan
Effective date
Dec 1, 2021
We identified it
Jun 20, 2026
Summary
Effective December 1, 2021, Oregon Health Plan (Medicaid) CCOs can no longer require primary care provider orders or prior authorization for COVID-19 home testing kits that use internet/smartphone interpretation, limited to 4 tests per month. CCOs must update their claims systems and guidance to remove these requirements.
Action Required
By December 1, 2021: Billing team must update claims systems to remove primary care provider ordering and prior authorization requirements for COVID-19 home testing kits that include internet connection or smartphone interpretation (up to 4 tests per month). Update billing guidance and ensure pharmacy claims processing reflects these changes. Prior auth may still be required for quantities exceeding 4 tests per month.