Oregon Medicaid Expansion

Oregon is fully participating in the Medicaid Expansion under provisions of the Affordable Care Act (ACA). 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.
Information about Oregon Health Plan, including beneficiary enrollment information, can be found at: http://www.oregon.gov/DHS/Pages/index.aspx.

Provider Participation

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.
The Medicaid website provides information about services covered by fee-for-service payments and payment amounts: 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

Some Oregon Health Plan beneficiaries are enrolled in managed care plans. Basic information can be found at: http://www.oregon.gov/oha/OHPB/Pages/index.aspx.
Some managed care plans cover individual Oregon counties and independent cities. The Medicaid website has jurisdictional information: http://www.oregon.gov/DHS/Pages/index.aspx.

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.

Reporting Problems

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:

http://www.oregon.gov/oha/healthplan/Pages/index.aspx

800-527-5772
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
Plan Website: www.allcarehealthplan.com
Provider Enrollment: http://www.allcarehealthplan.com/index.php/contact-us/

CareOregon, Inc.
Plan Website: http://www.careoregon.org/
Provider Enrollment: http://www.careoregon.org/Providers.aspx

Cascade Health Alliance
Plan Website: http://www.cascadehealthalliance.com/
Provider Enrollment: http://www.cascadehealthalliance.com/providerportal/

Columbia Pacific Coordinated Care Organization
Plan Website: http://www.colpachealth.org/
Provider Enrollment: http://www.colpachealth.org/main-group/for-providers

Eastern OR Coordinated Care Organization
Plan Website: www.odscompanies.com
Provider Enrollment: https://www.modahealth.com/medical/contactus.shtml

FamilyCare, Inc.
Plan Website: www.familycareinc.org
Provider Enrollment: http://www.familycareinc.org/index.php?/01/main/joining-familycare-panel/

Health Share of OR
Plan Website: http://www.healthshareoregon.org
Provider Enrollment: http://healthshareoregon.org/providers/

Intercommunity Health Network Coordinated Care Organization, Samaritan Health Services
Plan Website: www.samhealth.org
Provider Enrollment: http://www.samhealth.org/healthplans/providers/contractsandcredentialing/Pages/default.aspx

Jackson Care Connect
Plan Website: www.jacksoncareconnect.org
Provider Enrollment: http://jacksoncareconnect.org/sub-group/contact-us

Pacific Source Community Solutions Coordinated Care Organization
Plan Website: www.cohealthcouncil.org/
Provider Enrollment: http://www.cohealthcouncil.org/about-us/

Primary Health of Josephine County, LLC
Plan Website: www.primaryhealthjosephine.org
Provider Enrollment: http://www.primaryhealthjosephine.org/

Trillium Community Health Plan
Plan Website: www.trilliumchp.com
Provider Enrollment: http://www.trilliumchp.com/providers.php

Umpqua Health Alliance
Plan Website: www.umpquahealthalliance.org
Provider Enrollment: http://www.umpquahealthalliance.org/for-providers-and-staff

Western OR Advanced Health, LLC
Plan Website: Call 541-269-7400
Provider Enrollment: Call 541-269-7400

Willamette Valley Community Health, LLC
Plan Website: http://www.wvphealthauthority.org/medicaid/
Provider Enrollment: http://www.wvphealthauthority.org/medicaid/contact-us

Yamhill County Care Organization
Plan Website: www.yamhillcco.org
Provider Enrollment: http://www.yamhillcco.org/sub-group/contact