MedicaidAdministrativeMedium impact
Resolving conflicts between OARs 410-130-0700 and 410-130-0220
Oregon Health Plan·OR·Plan contract
Effective date
Jan 20, 2026
We identified it
Aug 19, 2026
Summary
Oregon Health Authority has identified conflicting requirements between two administrative rules (OARs 410-130-0700 and 410-130-0220) governing bundling and separate payment for medical-surgical professional services in the Oregon Health Plan. CCOs must immediately apply OAR 410-130-0220 when conflicts exist, and OHA is issuing a temporary rule filing for OAR 410-130-0700 (effective 1/20/2026 through 7/18/2026) while permanent rule revisions are drafted.
Action Required
Immediately: Billing team must review internal policies for bundled procedure payment rules and ensure compliance with OAR 410-130-0220 when conflicts with OAR 410-130-0700 exist. Update any billing system logic, fee schedules, or payment rules that reference OAR 410-130-0700 to align with OAR 410-130-0220 requirements. This applies specifically to non-participating provider payments and any contracted payment policies aligned with these rules. Contact Jason Daniels at jason.h.daniels@oha.oregon.gov if clarification is needed on specific procedure code bundling. Monitor the Chapter 410 Temporary Rule Filings page for the temporary rule filing effective 1/20/2026 and plan for permanent rule changes by 7/19/2026.