MedicaidAdministrativeLow impact
Clarification and waiver of certain credentialing requirements for “moderate” and “high” risk Providers
Oregon Health Plan·OR · Emergency Medicine·Plan
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Authority clarified that MCEs are no longer responsible for conducting fingerprint background checks and site visits for moderate and high-risk providers - OHA handles these requirements. Background checks only apply to high-risk providers, not moderate-risk providers like ambulance services.
Action Required
Oregon-based billing teams working with Coordinated Care Organizations or Dental Care Organizations: Confirm that moderate and high-risk providers are enrolled in Oregon's Medicaid program by checking OHA's Provider Enrollment files (updated weekly on OHA webpage) before contracting. No longer need to provide documentation of fingerprint background checks or site visits to MCEs.