For additional background on the State’s policy decisions regarding the Medicaid Expansion option, see: Background.
Medicaid in Oregon:
The OR Health Care Authority administers the state’s Medicaid program, called Oregon Health Plan.
Providers must enroll in the Medicaid fee-for-service program to receive payments for covered services.
Information about enrolling in the Medicaid fee-for-service program can be found at: http://www.oregon.gov/DHS/Pages/index.aspx.
In order to retain access to all Medicaid patients in the state, providers must also connect to the managed care plans individually.
Medicaid Managed Care:
Oregon Health Plan Beneficiaries Participating in Managed Care:
Managed care plans participating in Medicaid offer detailed information about covered benefits for individuals enrolling in their plans. This information is available on the managed care websites shown below.
The state Medicaid office is primarily responsible for examining and addressing issues with the Medicaid Managed Care plans offered in the state, and for working with the companies that offer them. If you are experiencing problems as a medical provider with the Managed Care plans or companies operating in the state, or if your patients are experiencing problems with the Managed Care plans or companies in the state, including trouble with access to medications, access to preferred providers, navigating the appeals process, excessive costs, or possible discriminatory policies, or any other problems related to the Affordable Care Act, please report these problems to the state Medicaid Office:
Additionally, if you are experiencing these or other problems, please report these problems to AAHIVM, so that we may track issues affecting our members, and seek additional policies remedies.
Managed Care Plans Participating in Medicaid:
AllCare Health Plan
Cascade Health Alliance
Columbia Pacific Coordinated Care Organization
Plan Website: http://www.colpachealth.org/
Eastern OR Coordinated Care Organization
Health Share of OR
Intercommunity Health Network Coordinated Care Organization, Samaritan Health Services
Jackson Care Connect
Pacific Source Community Solutions Coordinated Care Organization
Primary Health of Josephine County, LLC
Trillium Community Health Plan
Umpqua Health Alliance
Western OR Advanced Health, LLC
Plan Website: Call 541-269-7400
Provider Enrollment: Call 541-269-7400
Willamette Valley Community Health, LLC
Yamhill County Care Organization