MedicaidAdministrativeMedium impact
Provider Announcement
Oregon Health Plan·OR · Psychiatry·Plan contract
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Oregon Medicaid has corrected a clerical error in the CCO contract effective October 1, 2019. CCOs must now report Notices of Adverse Benefit Determination (NOABDs) for Applied Behavioral Analysis and Hepatitis C treatment for the previous calendar QUARTER (not year) within 45 days after each calendar quarter ends. Billing teams must update their reporting schedules and documentation processes immediately.
Action Required
REQUIREMENTS:
- Immediately: Billing and compliance teams must correct internal documentation and update the current CCO contract to reflect that NOABDs for Applied Behavioral Analysis and Hepatitis C must be reported on a QUARTERLY basis (previous calendar quarter), not annually.
- Before the next quarterly reporting deadline: Update reporting processes and checklists to ensure NOABD documentation is collected and compiled by calendar quarter rather than calendar year.
- Billing team: Modify any existing reports or tracking systems that were following the incorrect annual reporting schedule to align with quarterly reporting cycles.
- Compliance/Contracts: Verify all prior submissions made under the annual reporting interpretation and determine if corrective action is needed with OHA.
- Contact Cheryl Henning (Cheryl.L.Henning@dhsoha.state.or.us) if clarification is needed on retroactive compliance or prior submissions.