MedicaidAdministrativeHigh impact
Update #3 regarding Planned Parenthood claims
Oregon Health Plan·OR · OB-GYN·Plan contract
Effective date
Jul 28, 2025
We identified it
Aug 19, 2026
Summary
Oregon Medicaid CCOs must resume normal processing of Planned Parenthood claims effective July 28, 2025, following a federal court ruling. Claims for specific date ranges (July 4-7 and July 22-27, 2025) should continue to be held for standard Medicaid members, except Healthier Oregon Program (HOP) members. This supersedes previous OHA guidance from July 9, 11, and 24, 2025.
Action Required
By July 28, 2025: Billing team must update claim processing workflows to resume normal submission of all Planned Parenthood claims for dates of service on or after July 28, 2025 for Oregon Medicaid CCO members covered by the Medicaid Contract. Continue holding claims for the specified date ranges (July 4-7 and July 22-27, 2025) except for HOP members—verify member eligibility in billing system to identify HOP vs. standard Medicaid coverage. Notify providers and front-desk staff that the previous hold directive has been lifted for ongoing services. Update any internal hold lists or billing system rules that were implemented based on the July 9, 11, and 24 memos. Failure to resume processing may result in unnecessary claim delays and member access issues.