MedicaidAdministrativeHigh impact
Changes to Hospital Presumptive Eligibility processes, effective immediately
Oregon Health Plan·OR · Emergency Medicine·Provider
We identified it
Jun 20, 2026
Summary
Oregon Health Plan has implemented immediate changes to Hospital Presumptive Eligibility processes. This affects how hospitals determine and process temporary Medicaid eligibility for patients who may qualify for Oregon Health Plan coverage.
Action Required
Immediately: Billing and registration staff at hospital-based practices must review and implement the new Hospital Presumptive Eligibility processes per Oregon Health Plan requirements. Contact Oregon Health Plan or review the full policy document for specific procedural changes. Failure to follow updated processes may result in eligibility determination delays or claim denials.