MedicaidAdministrativeLow impact
Provider Announcement
Oregon Health Plan·OR · Pharmacy·Plan contract
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Summary
Oregon Health Authority (OHA) is waiving the requirement for Coordinated Care Organizations (CCOs) to attest that all Hepatitis C DAA drugs subject to 340B pricing were reimbursed at the 340B entity's actual acquisition cost plus dispensing fees. This waiver also eliminates the requirement to reprice drugs at the 340B ceiling price if reported costs are higher. The attestation was due April 30, 2021, for the 2020 benefit year, but this waiver retroactively removes this compliance obligation.
Action Required
No immediate billing workflow changes required. This policy waives a compliance attestation requirement for Oregon Medicaid CCOs, not a billing code or coverage change. Billing teams should note that 340B drug pricing attestation compliance for Hepatitis C DAA drugs is no longer required by OHA for the 2020 benefit year. If your practice is part of a CCO, ensure pharmacy and compliance teams are aware this attestation is waived. No system updates or claim submission changes are necessary.