Oregon Health Authority: Provider Matters (Oregon Health Plan provider bulletin) · July 10, 2026 · Primary source
Join OHA's July 23 Rules Advisory Committee (RAC) to provide feedback on updates to billing rules
Summary
The Oregon Health Authority issued a July 10, 2026 omnibus provider update covering multiple Medicaid policy changes: a July 9, 2026 effective rule amendment under OAR 410-121-0146 allowing up to a 365-day supply dispensing for select hormone medications; release of the July 1, 2026 Behavioral Health Fee Schedule with federally mandated medication rate adjustments, youth service rate increases, and updated MAT billing guidance for methadone take-home doses; a July 31, 2026 transition from the Level of Service Inventory to the interRAI Community Mental Health assessment tool for 1915(i) HCBS eligibility determinations; and adoption of a new OAR 410-172-0660 requiring board-registered behavioral health associates to work within COA-certified agencies to bill Medicaid. The update also covers upcoming 2027 CCO capitation rate development milestones and a July 23 Rules Advisory Committee meeting on billing rule changes.
What this may mean
The interRAI CMH instrument replaces the LSI for 1915(i) HCBS program eligibility effective July 31, 2026, directly changing how residential service rates are determined and how reconsiderations are submitted for adult behavioral health HCBS enrollees. The OAR 410-172-0660 behavioral health associate billing rule, filed July 1, 2026, creates a one-year compliance window ending July 1, 2027, for unlicensed associates to obtain COA coverage; the expanded hormone medication dispensing limit to 365 days under OAR 410-121-0146 takes effect July 9, 2026.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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