141-3830-10012026.pdf: OAR 410-141-3830 amended to adopt, by reference, the October 1, 2026 Prioritized List of Health Services created by the Health Evidence Review Commission for use in determining benefits for the Oregon Health Plan. No public comment was received.

The Oregon Health Authority (OHA), Health Systems Division, filed Permanent Administrative Order DMAP 39-2026 on September 29, 2026, amending Oregon Administrative Rule (OAR) 410-141-3830, effective October 1, 2026. The amendment adopts by reference the October 1, 2026 Prioritized List of Health Services, as generated and maintained by the Health Evidence Review Commission (HERC), for use in defining the covered benefit package under the Oregon Health Plan (OHP). The amended rule incorporates the October 1, 2026 Prioritized List in its entirety, including all line items, diagnosis and treatment codes, guideline notes, statements of intent, coding specifications, and annotations, funded through line 470. The October 1, 2026 Prioritized List supersedes the February 1, 2026 Prioritized List for services provided on or after October 1, 2026, and includes interim modifications reported as required under ORS 414.690(7) and (8). The rule authorizes OHA to apply criteria listed in Statements of Intent and Practice Guidelines from the Prioritized List to codes and lines not explicitly specified in a given guideline note, and to services such as diagnostic, ancillary, and excluded services, irrespective of their inclusion on specific lines of the Prioritized List. Statutory authority is ORS 414.065 and 413.042; statutes implemented are ORS 414.065 and 414.727. No public comment was received during the comment period opened by notice filed August 7, 2026. The agency approved the order on September 29, 2026, and the rule took effect October 1, 2026.