Coverage for OHP members under age 21 is changing on January 1, 2023

December 6, 2022

Coverage for OHP members under age 21 is changing on January 1, 2023  

Effective January 1, 2023, the Oregon Health Authority (OHA) and coordinated care organizations (CCOs) are required to cover any medically necessary and medically appropriate service for OHP-enrolled children and youth until their 21^st birthday, regardless of the Prioritized List, under the federal Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.

OHA has developed the following materials to share information about this change:

·         EPSDT Guidance Document for CCOs

·         EPSDT Policy Change Memo for OHP providers

·         EPSDT Guidance for OHP Providers 

Note: Webinars are in development for providers regarding this guidance. Information about these webinars will be shared via Provider Matters and will be posted at Oregon.gov/EPSDT

·         EPSDT Fact Sheet for OHP members (available soon in additional languages)

All of these materials and additional information can be found at OHA’s EPSDT webpage at Oregon.gov/EPSDT. This page will be updated with new information and materials as they become available.

Please reach out to EPSDT.Info@odhsoha.oregon.gov with any questions.