2024-016 Oregon Department of Human Services/Oregon Health Authority
Improve documentation for provider eligibility determinations and revalidations
Management Response:
We agree with this recommendation.
OHA – Medicaid (Todd Howard) - At the next Provider Enrollment meeting on April 17, 2025, we wi...
2024-016 Oregon Department of Human Services/Oregon Health Authority
Improve documentation for provider eligibility determinations and revalidations
Management Response:
We agree with this recommendation.
OHA – Medicaid (Todd Howard) - At the next Provider Enrollment meeting on April 17, 2025, we will conduct an additional training on the ownership and disclosure form, in particular the requirement around the managing employee disclosure. We will also work with our CCO contract administrator, unit lead worker and staff that process the annual CCO ownership disclosure forms to ensure all disclosures and attachments are obtained.
ODHS-Aging & People with Disabilities (Jennifer Stallsworth)
The Office of Aging and People with Disabilities is committed to ensuring the Provider Enrollment Agreements and I-9 forms are on accurate and records are stored and retained properly. Corrective Actions Taken & In Progress
• Improved Provider Enrollment & Renewal Forms – On or before March 31, all new and renewing providers will have the option to complete the Provider Enrollment Application and Agreement (PEAA), I-9, W-4 (federal and state), and HCW Guide Agreement Form through DocuSign and submit them electronically through email, which will assist in the accuracy of forms completion and mitigate human errors in completing forms.
• Local Office Verification Step – An Action Request (AR) transmittal will require local offices to verify that a properly completed I-9 is on file during provider renewal process.
• Training & Resources – We will develop a Quick Resource Guide (QRG) with clear instructions and visual examples to help staff verify employment documents accurately and store them appropriately.
• Quality Assurance Enhancements – The Provider Relations Unit (PRU) will implement a Quality Assurance check for I-9 forms during provider enrollment and renewal process.
• E-Verify – The department is developing a proposal with an implementation plan using the Department of Homeland Security’s E-Verify+ system as an electronic verification tool for employment eligibility. We will seek leadership approval by July 1, 2025, with a plan to implement by March 31, 2026.
Resolution of Questioned Costs
The department has obtained the missing I-9 documentation and will not reimburse the federal agency for the questioned costs.
We are confident these measures will ensure full compliance and improve the accuracy and efficiency of our provider enrollment process.
Anticipated Completion Date: March 31, 2026
Contact person: Jennifer Stallsworth, Chief of Staff, ODHS APD, April Gillette, OHA Medicaid Division, Strategic Operations & Improvement Director