MedicaidAdministrativeMedium impact
Provider Announcement
Oregon Health Plan·OR · Infectious Disease·Plan contract
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
This policy clarifies that the quarterly Hepatitis C treatment documentation submission requirement for CCOs under 2018-2019 contracts has been eliminated for CCO 2.0 contracts effective October 1, 2019. Billing teams should stop submitting quarterly Hepatitis C DAA request and approval/denial documentation to OHA, and instead follow current requirements in CCO 2.0 contract exhibits.
Action Required
Billing and compliance teams at Oregon Health Authority-contracted CCOs should immediately cease quarterly Hepatitis C treatment documentation submissions that were previously required under the November 9, 2018 memo. For current CCO 2.0 contract holders: Review Exhibit C, Section 6.a. and Exhibit I, Section 10.b. of your CCO 2.0 contract to identify any ongoing Hepatitis C documentation requirements that remain in effect. Update internal compliance procedures and audit schedules to reflect the elimination of quarterly submission obligations. No claims will be denied for non-submission of previously-required quarterly Hepatitis C documentation going forward. Contact Cheryl Henning (Cheryl.L.Henning@dhsoha.state.or.us) if CCO 2.0 contract terms regarding Hepatitis C documentation require clarification.