MedicaidAdministrativeLow impact
MCE Guidance for Aug. 9 Claim Denial Memo
Oregon Health Plan·OR·Plan contract
We identified it
Jun 20, 2026
Summary
Oregon Health Authority requires Medicaid Managed Care Organizations (MCOs) and Dental Care Organizations (DCOs) to report historical data on claim denials and missing denial notices from 2015-2021. This is a data collection requirement for MCEs, not a direct billing practice change.
Action Required
By November 21, 2021: Medicaid MCEs and DCOs must submit via email the total number of claim denials by year, total number of claim denial notices not issued by year, and total number of clean claims by year for claims adjudicated between 1/1/2015-8/20/2021. Exclude Cover All Kids members from counts. This applies only to Oregon Medicaid managed care entities, not direct billing practices.