OR HB2225

Establishes minimum reimbursement rates for Medicaid providers beginning January 1, 2026, using an $85 conversion factor multiplied by resource-based relative value units for primary care, optometry, dental care, and behavioral health services

Sets behavioral health reimbursement at the greater of the $85 conversion factor calculation or 150% of average commercial insurance rates; dental care at the greater of the $85 calculation or 100% of average commercial rates

Requires coordinated care organizations (CCOs) to pay contracted providers these minimum amounts, excluding bonus or quality incentive payments, and to spend allocated global budget funds for these services solely on these service categories

Mandates annual 3.4% increases to minimum reimbursement amounts after 2026

Requires Oregon Health Authority to seek federal CMS approval within 60 days and submit a report to the legislature by December 31, 2031 on whether the rate changes reduced wait times, increased access, improved health outcomes, and reduced costs