Provider Notices


Claims

12/4/2018 9:10:19 AM

Change to sterilization consent requirements effective 1/1/2019

Starting January 1, 2019, the Oregon Health Authority (OHA) will no longer require a sterilization consent form for procedures that are unrelated to voluntary sterilization but would result in sterilization (such as ovarian cancer surgery). This means:

  • Providers will no longer need to collect a consent form for procedures that cause sterilization if the purpose of the procedure is something other than sterilization.
  • OHA will still require consent when the purpose of the procedure is sterilization.

Starting January 1, some claims will process without suspending for a consent form. However, some claims will continue to suspend for additional information, such as chart notes. In these cases, providers will need to submit documentation that shows:

  • The patient’s reproductive capacity remained intact after the procedure, or
  • The patient was sterile before the procedure, or
  • The purpose of the procedure was to treat illness/injury and not to cause sterilization.

To learn more about OHA’s sterilization consent requirement, see Oregon Administrative Rule 410-130-0580.

 

Ambulatory surgical centers can bill OHA for post-procedure long-acting reversible contraceptive placement effective 1/1/2019

Starting January 1, 2019, OHA will pay for long-acting reversible contraceptive (LARC) placement provided in an ambulatory surgical center (ASC) to Oregon Health Plan (OHP) members not enrolled in a CCO for physical health care.

  • This means ASCs will be able to bill OHA fee-for-service for LARC placement the same as clinics, hospitals, and other settings.
  • LARC placement includes IUDs and subdermal implants.

 


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