OHP Stakeholder Information

This page provides information for OHP stakeholders - The providers, clients, organizations and other partners interested in how the Oregon Health Plan works.

If you eSubscribe to this page, you will receive e-mail notification of stakeholder announcements from DMAP. You can also see the most recent announcements sent to OHP Stakeholders at this link. 

 Receive OHP Stakeholder updates by email

• About CMS
• About DHS
• About OHP
• Client and constituent resources
• Policies, rules and guidelines
• Reports and publications

Make sure to check the OHP Public Notices and Meetings page for opportunities to provide comment on proposed or upcoming changes to DMAP program and policy.

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About CMS

The federal Centers for Medicare and Medicaid Services (CMS) oversee and fund state Medicaid and SCHIP programs, administer Medicare, and oversee HIPAA/NPI implementation. CMS approved waivers of federal Medicaid requirements that allow Oregon to expand its Medicaid program to include an expansion population under the OHP Standard program, and allow Oregon to use the Prioritized List of Health Services to determine service coverage.

• Medicare 
• Medicaid 
• HIPAA 
• SCHIP - Detailed information about Oregon's CHIP can be found here. On the CMS site, select "CHIP Approved State Plan Information," on the left-hand menu, then select "Show only items whose State is Oregon" on the resulting page.

About DHS

DMAP is a division of the Department of Human Services (DHS), which coordinates the biennial budget development process that funds DMAP operations. DHS also oversees initiatives such as Healthy Kids and the MMIS Replacement Project. 

• For more information about the DHS budget, go to this link.
• For information about how DMAP fits into the DHS structure, go to this link.

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About OHP

From 1989-1993, the Oregon Legislature passed a series of laws known collectively as the Oregon Health Plan. Senate Bill 27 (1989) extended Medicaid coverage to Oregonians with income below the federal poverty level and established a set of benefits based on a prioritized list of health services.

The OHP is a public/private partnership made up of three main components: 

• Medicaid reform and expansion - View Oregon's Medicaid State Plan, which defines how each state will operate its Medicaid program.
• Private and employer-sponsored insurance subsidy - To help those not eligible for Oregon Medicaid. Go to the Office of Private Health Partnerships Web page for more information.
• The Prioritized List of Health Services - The Oregon Health Services Commission maintains the list, which allows DMAP to control costs of the Medicaid program. 

Client and constituent resources

• Client mailings 
• Resources in Oregon counties 
• Client Advisory Services Unit (CASU) 
• Governor's Advocacy Office (GAO) 
• Managed care plans in Oregon counties 

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Policies, rules and guidelines

The OHP Policies page provides links to the current Oregon Administrative Rules and supplemental information for OHP health care providers and managed care organizations.

• OHP Public Meetings - Public meetings related to changes to DMAP policy and operations.
• Proposed rule revisions and hearings - Proposed changes to rules in current DMAP programs.

Reports and publications

Information on this page is highly varied, ranging from technical material to the number of Oregon Health Plan enrollees statewide and by county. This page also includes a history of the Oregon Health Plan, whose development began in the late 1980s and which was introduced Feb. 1, 1994.

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