Rights And Responsibilities

Important Rights for OHP Clients

As an OHP client, you have the right to:

Be treated with dignity and respect; the same as other patients;

Choose your provider;

Tell your provider about all your health concerns;

Have a friend or helper come to your appointments, and an interpreter if you want one;

Get information on all your OHP-covered and non-covered treatment options;

Help make decisions about your health care, including refusing treatment, without being held down, kept from other people, or forced to do something you don’t want to do;

A referral or second opinion, if you need it;

Get care when you need it, any time of day or night;

Behavioral health and family planning services without a referral

Help with addiction to cigarettes, alcohol and drugs without a referral;

Handbooks and letters that you can understand;

See and get a copy of your health records, unless your doctor thinks it would be bad for you;

Limit who can see your health records;

A “Notice of Action” letter if you are denied a service or there is a change in service level;

Information and help to appeal denials and ask for a hearing;

Make complaints and get a response without bad treatment from your plan or provider;

Free help from the Oregon Health Authority Ombudsperson with problems at 503-947-2346 or toll free at 1-877-642-0450, TTY 711

OHP Client Responsibilities

As an OHP client, you agree to:

Find a doctor or other provider you can work with and tell them all about your health

Treat providers and their staff with the same respect you want

Bring your medical ID cards to appointments, tell the receptionist that you have OHP and any other health insurance, and let them know if you were hurt in an accident

Be on time for appointments

Call your provider at least one day before if you can’t make it to an appointment

Have yearly check-ups, wellness visits and other services to prevent illness and keep you healthy

Follow your providers’ and pharmacists’ directions, or ask for another choice

Be honest with your providers to get the best service possible

Call your case worker when you move, are pregnant or no longer pregnant

Report Medicaid fraud. Please tell us if you think you see fraud, like charging for a service you didn’t get or someone using another person’s ID to get OHP benefits. Call or write to the following if you think you see fraud, such as:

  • Charging for a service you didn’t get; or
  • Someone using another person’s ID to get OHP benefits.

To report provider fraud:
DHS Provider Audit Unit
P.O. Box 14152
3406 Cherry Avenue N.E.
Salem, OR 97309-9965
Phone: 1-888-372-8301
Fax: 503-378-2577

To report client fraud:
DHS Investigations Unit
P.O. Box 14150
Salem, OR 97309
Phone: 1-888-372-8301
Fax: 503-373-1525

You can also report client and provider fraud online at: www.oregon.gov/dhs/abuse/Pages/fraud-reporting.aspx at the bottom of OHP Client Responsibilities