Coronavirus (COVID-19) Provider and Community Partner FAQ
Thank you for all you are doing to keep our members healthy. Jackson Care Connect has been actively monitoring this situation and working in coordination with local and state public health bodies. We are committed to supporting you and
making sure our members get the care they need.
Download a PDF with more resources and information here.
Download a PDF with more resources and information in Spanish here.
Near the beginning of the COVID-19 pandemic, the government labeled it an official Public Health Emergency (PHE). At that time, all states were ordered to pause the redetermination process. Within 60 days of when the PHE period ends, OHA must restart the redetermination process to confirm that all OHP members still qualify for Medicaid coverage through OHP. Learn more about the redetermination process here.
As you know, the FDA has fully approved the Pfizer vaccine and approved the Moderna and Johnson & Johnson vaccines for emergency use. We are here to support you as the vaccine rolls out. Here is what we know now:
- Click here to see Jackson County's site for the most current information on how and where to get vaccinated.
- Click here to read our provider FAQs about the vaccine and vaccine billing.
- Click here to read our billing FAQ for COVID-19 monoclonal antibody (mAb) treatment.
- The Oregon Health Authority is offering guidance to providers. You can learn more on their provider page by clicking here. Read OHA’s COVID-19 Vaccine Administration Site and Provider Guidance (updated May 19, 2021) by clicking here.
- CDC summary guidance for use of the COVID-19 vaccine
- OHA’s public-facing COVID-19 information is found at covidvaccine.oregon.gov. This website features the Get Vaccinated Oregon tool. Learn more about this tool here.
- Everyone age 6 months and over is eligible to receive the COVID-19 vaccine:
- People ages 6 months to 17 are only eligible for the Pfizer and Moderna vaccines.
- Children ages 6 months to 11 will receive a pediatric version of the vaccine.
- Everyone ages 6 months to 14 must have permission from a parent or guardian.
- We are encouraging members to speak with their providers and visit the public-facing OHA COVID-19 vaccine page for more information. Members can find out where they can get their vaccine by using one of the following options:
- The federal government is distributing the COVID-19 vaccine to retail pharmacies in Oregon. We are advising members to contact their local pharmacy for details. They can learn more at the following links:
- You can also find information specific to your county at the following websites:
- COVID-19 vaccine transportation resources
- Janssen: Required fact sheet for Johnson & Johnson vaccine recipients and caregivers: English | Spanish
- Jackson Care Connect wants to help you and your patients have the best experience, which is why we help you coordinate live interpreters for patients who speak a language other than English. Click here to learn about our resources.
- For additional resources, see COVID-19 vaccine webpages from the CDC and the FDA.
- Tools to support conversations with dental patients about the COVID-19 vaccine.
- As we learn more, we will continue to update this page with more information and resources.
There are local and national lines available for physicians looking for emotional support during this time.
- OPAL-C emotional support for providers: The Oregon Psychiatric Access Line (OPAL) is now opening OPAL-C (COVID-19), providing emotional support to prescribing providers in the state.
- 503-346-1000, 9 a.m. to 5 p.m. Monday through Friday
- Physician Support Line: Free, confidential, national support line run by volunteer psychiatrists.
- 888-409-0141, 5 a.m. to 9 p.m. every day
Testing and specimen collection
For guidance on test ordering, specimen collection and processing please consult your contracted lab, hospital or OHA for the state lab. Medicare and the AMA have released codes to use when testing for COVID-19, which can be found in the "Lab test" section of the Oregon Medicaid COVID-19 Provider Guide.
COVID-19 antibody testing
During the COVID-19 emergency, CareOregon will follow Oregon Health Plan (OHP) coverage guidance for COVID-19 antibody testing. COVID-19 antibody testing (also known as serology testing) to diagnose SARS-CoV-2 coverage criteria:
- Uses tests that have FDA Emergency Use Authorization (EUA) or FDA approval and
- Is to evaluate a hospitalized person under age 21 for possible multisystem inflammatory syndrome in children (MIS-C).
COVID-19 home tests available for members
Home tests for COVID-19 are now available for Medicaid members who have COVID-19 symptoms or may have been exposed to someone with COVID-19. Members may get up to eight tests every 30 days. Many brands of home tests are fully covered, but not all. See our formulary for details.
Members do not need a prescription for tests that do not require prior authorization. All tests must be dispensed by a pharmacy. The Oregon Board of Pharmacy allows pharmacists to prescribe COVID-19 home tests.
Members may be able to get reimbursement if they pay for tests out of pocket. Members should submit for reimbursement using this form. Receipts must be included.
For pharmacies: Processing home tests
- Pharmacies should submit claims for home tests to the Pharmacy Benefit Manager (PBM) through the pharmacy point of sale system.
- Home tests should not be billed through the medical benefit. Please do not submit these to QNXT.
- The prescribing provider on these claims should include a pharmacist that has a current Oregon Medicaid ID.
Telephone and video appointments
Current codes and guidance for telephone and/or video appointments
- Telemedicine technical assistance guide
- Behavioral health technical assistance guide
- Telehealth FAQ for providers
- Primary care providers: Codes for telehealth and other communication-based services in response to COVID-19
- Behavioral health providers: Codes for services via telephone in response to COVID-19
- Dental providers (CareOregon dental providers and members ONLY): Teledentistry Codes for COVID-19
- Expanded teledentistry guidance, including preventive services
Additional telehealth reference material
- OHLC telehealth service recommendations – Adult primary care
- OHA COVID-19 for Oregon Health Plan partners (benefit information)
- Medicare telemedicine health care provider fact sheet (3/17)
- HHS: Notification of enforcement discretion for telehealth remote communications during the COVID-19 nationwide public health emergency
- Payment parity implementation for two-way audio-video visits
- Telehealth service recommendations for pediatric primary care (PDF)
Behavioral health resources:
- Mental health considerations for older adults and individuals receiving care in facility-based settings during the COVID-19 pandemic
- COVID-19 prioritization guidelines for behavioral health populations
- Substance Abuse and Mental Health Services (SAMHSA): Coronavirus resources
- SAMHSA: Medication-assisted treatment guidance
- Practitioners Clinical Support System: Telemedicine guidance on Buprenorphine
- American Society of Addiction Medicine: Alcohol withdrawal management
- HHS: Emergency situation preparedness, planning and response
- Oregon Recovery Network: Recovery support resources
- American Academy of Family Physicians: Virtual visit algorithm
- Synergy: Flare-ups during COVID-19
- Resource digest - June 19, 2020
- Resource digest - June 26, 2020
- Resource digest - July 10, 2020
- Resource digest - August 17, 2020
- Resource digest - August 24, 2020
- Resource digest - September 22, 2020
- Resource digest - October 5, 2020
- Resource digest - October 14, 2020
- Master Resource List
- OHA COVID 19 updates
- CDC COVID 19 guidance
- OHA Strategies to limit spread and increase capacity
- OHA guidance for health systems regarding COVID-19 testing
- OHA infection control guidance for in-person interpreters and providers
- Oregon Medical Board topic of interest COVID-19
- COVID-19 guidance: Non-emergent medical transportation (NEMT)
- CareOregon Dental COVID-19 guidelines for providers
- UCSF School of Medicine: Contraception during COVID-19: Best practices and resources
- Better Care Playbook: Addressing complex care needs amid COVID-19
- Federal Communications Commission: COVID-19 telehealth program
- Drive-thru primary care: Tips and considerations
- COVID-19 communication for members who are deaf or hard of hearing
- COVID-19 communication for members who cannot speak
- Visual communication tools for members with disabilities
- Note: Providers serving Medicaid members may not charge members for personal protective equipment (PPE) used during their visits. Medicaid regulations require that providers accept Medicaid payment as payment in full, meaning providers are not allowed to bill Medicaid members for any extra PPE that may be required to perform medical or dental services. Clinics are responsible for providing PPE for all members of the care team, including interpreters.
Current guidance for members/patients:
The guidance being given to members/patients during the coronavirus pandemic. If you have questions about what to tell patients, this section can help. This includes links to interpretation services.
- If a member has symptoms of COVID-19, CareOregon is recommending they call their primary care provider. You can best advise members on the next steps, including how to get tested.
- We are encouraging members to stay at home and practice social distancing whenever possible. We are reinforcing that this is the most effective way to help prevent the spread of COVID-19.
- You should notify members about how appointments are being handled. We are ensuring members that clinics are still seeing patients — both in person and via telehealth — and taking precautions to keep members and staff safe.
- We are urging clients receiving mental health and substance use treatment services to contact their providers directly to learn how to access services. Many providers are shifting to offering services by phone, though some in-person visits are still available. Please see the telehealth and phone-based services guidelines for behavioral health included above.
- Elective procedures have resumed.
- Members still have access to CareOregon’s provider network. None of their benefits have changed, and CareOregon is still committed to helping members meet their physical, dental, mental health and addiction-related care needs.
- Members and providers still have access to interpretation services. CareOregon’s approved interpretation vendors are Passport to Languages and Linguava. To arrange for an interpreter to be present during an appointment — whether by phone or in-person — complete the CareOregon Interpreter request form found on our Provider Policies and Forms webpage. You can also access our vendors’ online systems to request and confirm an interpreter:
- Rides to appointments are still available for members. Members should call Ride to Care at 855-321-4899 to ask about service availability.
We’ve provided answers to other common questions below. This page will continue to be updated with more information as it becomes available.
Health-related servicesLearn about health-related services to cover immediate member needs like cell phones and hotel rooms. Find the forms you need to request health-related services.
Limitations of health-related services: The Oregon Administrative Rules restrict health-related services to items not paid for with grant money, funding separate from CCO contract revenue, or normal clinical service billing. In other words, health-related services may be used only if other funding is not available. Before you make a request, please be sure there is no other funding available.
CareOregon is continuing to offer health-related services of many kinds, but in particular we are striving to meet the most immediate member needs:
- Cell phones: With many providers moving to delivery of services via telehealth, we want to ensure that members have access to a phone. We are working with a provider to offer flip phones and simple smart phones to members.
- Hotel rooms: For members who are at higher risk due to underlying health conditions, have been exposed to COVID-19 or are showing signs of the virus, we are attempting to find hotel rooms where members can stay while they await test results or other care that does not meet the criteria for the county’s motel sheltering program.
There are two ways you can submit requests for health-related services for members:
- Use our standard Health-Related Services Flexible Services Funding Request form to
make requests for cell phones, hotel rooms or other health-related services for individual members.
- Please remember that requests for health-related services must be directly related to members’ treatment plans and require chart notes to justify the request.
- Bulk items are available to help clinics and providers ensure a constant supply of the most needed items. To order items in bulk — including cell phone minutes, transit passes, sleeping bags, hygiene projects and more — fill out our
Bulk Purchase Request form.
- Bulk requests may take up to 14 business days for review and delivery.
- Clinics and county teams may make bulk requests one time per month.
- Requests should be submitted by supervisors or managers.
- Clinics/teams are required to keep a Bulk Request Tracking document and submit it before new orders can be fulfilled.
Download the COVID-19 health-related services resource worksheet:
Information about what to do if you think someone in your care has coronavirus, and other resources for clinic staff.
What should clinic staff do if they suspect someone in their care has the coronavirus?
Please reach out to the CDC or OHA. They can help you with any suspected cases and suggest the appropriate next steps.
Resources for health care staff:
- CDC: cdc.gov/coronavirus/2019-ncov/hcp/caring-for-patients.html
- OHA: oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/emerging-respiratory-infections.aspx
Who should we call if we have questions?
If providers or clinic staff have other questions about COVID-19, they should reach out to OHA directly.