MedicaidAdministrativeHigh impact
Anticipated Impacts of H.R.1 and other federal changes on Oregon’s CCOs
Oregon Health Plan·OR·Plan
Effective date
Jan 1, 2027
We identified it
Jun 20, 2026
Summary
H.R.1 introduces major changes to Oregon Medicaid (OHP) including work requirements for certain populations, increased copayments starting October 2028, and mandatory transition of Healthier Oregon members from CCO managed care to fee-for-service by January 2027. This affects over 100,000 members and will require significant billing system updates.
Action Required
By January 1, 2027: Billing team must update systems to handle transition of 100,000+ Healthier Oregon members from CCO managed care to OHP Open Card (fee-for-service). Update claims adjudication systems to track copayment billing data by October 2028. Modify encounter data reporting to include copay-applicable services. Train staff on new eligibility verification processes and work requirement documentation. Update provider credentialing for fee-for-service billing requirements.