Oregon Health Plan ABA and the OHP approval process
OHP covers ABA to treat diagnosed autism or self-injurious behavior. A physician, psychologist, or a nurse practitioner or physician associate who specializes in developmental medicine must recommend it, and the evaluation must include a standardized tool such as the ADOS. The ABA provider then asks OHP to approve a treatment plan and returns every six months for continued approval. Members under 21 are covered under EPSDT, and OHP rules allow intensive ABA for members age 13 and older when medically appropriate.
- Clackamas, Multnomah and Washington counties: Health Share of Oregon or Trillium Community Health Plan Tri-County.
- Marion and Polk counties: PacificSource Community Solutions Marion/Polk.
- Lane County: Trillium Community Health Plan Southwest.
- Jackson County: Jackson Care Connect.