MedicaidDocumentationMedium impact
1915(i) Home and Community Based Services (HCBS) Referral Documentation Standards Update
Oregon Health Plan·OR · Psychiatry, General Practice·Provider
Effective date
Jul 31, 2026
We identified it
Jul 31, 2026
Summary
Oregon's 1915(i) HCBS program is eliminating the requirement for Mental Health Assessments, Residential Care/Treatment Plans, and Progress Notes in referral packets effective July 31, 2026. Referrals now only need documentation dated within 18 months confirming a qualifying psychiatric diagnosis signed by a QMHP or LPHA. This reduces administrative burden and streamlines the referral process.
Action Required
By July 31, 2026: Billing and referral teams must update 1915(i) HCBS referral submission procedures to comply with the new documentation standards. Stop requiring Mental Health Assessments, Residential Care/Treatment Plans, and Progress Notes in referral packets. Ensure all referrals submitted through the Comagine Health Provider Portal or via secure email/fax include only: (1) documentation dated within past 18 months, (2) confirmation of qualifying psychiatric diagnosis, and (3) signature from QMHP or LPHA. Update internal referral checklists and provider communication templates. Monitor for updated referral forms from OHA. Contact 1915i.MedicaidPolicy@odhsoha.oregon.gov with implementation questions.