MedicaidAdministrativeMedium impact
2025 Changes to Enrollment Reconciliation Certification documents
Oregon Health Plan·OR·Plan
Effective date
Jun 30, 2025
We identified it
Aug 19, 2026
Summary
Oregon Health Authority has consolidated two separate Enrollment Reconciliation Certification forms into a single form with a checkbox to indicate whether discrepancies were found. The updated form, reporting guide, and Excel template are now available, with mandatory use required starting with the June 30, 2025 reconciliation certification. Previous form versions will not be accepted after that date.
Action Required
By June 30, 2025: Medical billing team must transition from using separate 'No Discrepancies' and 'Discrepancies Found' Enrollment Reconciliation Certification forms to the new consolidated form. Billing staff responsible for CCO enrollment reconciliation reporting must: (1) Download the new form and updated Excel template from the OHA CCO Contract Forms webpage, (2) Review the updated Coordinated Care Organization Enrollment Reconciliation and Discrepancy Reporting Guide, (3) Configure any templates or processes to use the checkbox field to indicate discrepancy status, (4) Test the new form and template before June 30, 2025. Immediate action recommended: CCOs are encouraged to adopt the new form and template as soon as possible before the mandatory effective date. Consequence of inaction: Submissions using the previous form versions after June 30, 2025 will not be accepted by Oregon Health Authority.