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Oregon Health Authority (OHA) expectations for Health-Related Social Needs (HRSN) service transitions for Healthier Oregon members
Effective date
Jan 1, 2027
Identified
Aug 29, 2026
Summary
Effective January 1, 2027, approximately 102,000 Healthier Oregon members will transition from Coordinated Care Organizations (CCOs) to OHP Open Card (managed by Acentra). CCOs must process HRSN (Health-Related Social Needs) service requests on specific timelines through December 31, 2026, then transfer authorization responsibilities to Acentra. This is NOT a service termination—HRSN services will continue uninterrupted under the new plan.
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What to do
Action · 14 steps
01REQUIREMENTS:
By November 19, 2026: Billing and authorization teams must establish internal tracking systems to identify and process all complete HRSN requests received on or before this date.
02These requests MUST receive authorization decisions and, if approved, at least one month of service delivery must begin before December 31, 2026.
03Do not issue Notices of Adverse Benefit Determinations (NOABDs) for approved services—instead, communicate to affected Healthier Oregon members that OHP Open Card will cover and coordinate HRSN services starting January 1, 2027.
04By December 4, 2026: Billing team must cease issuing service authorization extensions unless the member explicitly requests one.
05Update authorization protocols to reflect this cutoff date.
06By December 17, 2026: Complete all authorization decisions and referrals for requests received between November 20 and December 17.
07If an Open Card-enrolled HRSN provider cannot be identified, send authorization information to Acentra immediately and notify the member that OHP Open Card will complete the referral.
08By December 31, 2026: For requests received between December 18-31, make best-effort eligibility screening and authorization decisions.
09If unable to complete, refer incomplete requests to Acentra and inform members that OHP Open Card will make the authorization decision.
10For truly incomplete requests not resolved by this date, notify members and encourage them to submit requests directly to Acentra.
11After January 1, 2027: All HRSN service authorizations, referrals, and coordination transfer to Acentra (OHP Open Card).
12Billing team should coordinate with Acentra for any member service continuation questions.
13ONGOING: Monitor OHA's monthly list of HRSN service providers enrolled to serve Open Card members (provided by OHA).
14Participate in technical assistance calls if your CCO is identified as having HRSN backlogs.
Original notice
Oregon Health Authority (OHA) expectations for Health-Related Social Needs (HRSN) service transitions for Healthier Oregon members
oregon.gov · Always check the source before changing claims.