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Appeal an OHP health-service denial or reduction
Oregon Health Authority · Shared Oregon or applicable federal route
Follow the correct CCO appeal or OHA hearing route for an adverse health-service decision.
Where and how to proceed: prepare, file and follow up
Start here: Identify whether the notice came from a CCO or OHA and read its reason and appeal instructions.
1. Is this for me?
OHP members receiving a service denial, reduction or termination notice from a CCO or OHA. Eligibility decisions may use different notice instructions.
Service area: Oregon or applicable federal route; confirm venue and agency jurisdiction.
2. What should I prepare?
Some documents may be conditional. Ask about alternatives. Checkmarks are temporary and are not saved or sent.
3. Where and how do I submit?
Read the linked publisher instructions to confirm the receiving office, accepted submission method and current forms. This page has not separately verified those details. A county filter does not decide the correct court or filing location.
- Identify whether the notice came from a CCO or OHA and read its reason and appeal instructions.
- For a CCO decision, appeal to the CCO first; for an OHA service denial, request an OHA hearing.
- Ask your provider to supply information supporting the ordered service; give written permission if the provider appeals for you.
- Use OHA’s secure hearing form when a hearing is available and attach the applicable notice.
- If already receiving the service, request continued coverage promptly; ask for expedited review if the medical urgency qualifies.
Timing: The page states 60 days from the CCO adverse notice to appeal; 120 days from the CCO appeal-resolution notice for an OHA hearing; 60 days from an OHA denial for a direct hearing. Continued services have a separate shorter deadline.
4. What will it cost?
Details to confirm with the provider
Fees and fee-waiver eligibility have not been separately verified for this route. Check the current provider instructions. For a court filing, ask the court about its fee-waiver or deferral forms.
5. What happens after I submit?
Details to confirm with the provider
Keep a copy of what you send and its confirmation or receipt. Ask the receiving office how to track it, when to expect a response and how it will request missing information. These follow-up details have not been separately verified for this route.
6. What if something goes wrong?
Details to confirm with the provider
Read any returned filing, correction request or denial notice promptly. Ask the responsible office for the correction, review or appeal instructions and the deadline that applies to your notice. This guide does not verify a route-specific appeal process.
Language, disability and offline help
Ask the receiving office about language assistance, disability accommodations and an alternative to online submission. Available options have not been separately verified for this route.
Continued services may have repayment consequences if the denial is upheld. Follow the exact notice and do not confuse an informal complaint with an appeal.
Sources and review date
Guidance reviewed 2026-10-11. Read the current publisher instructions before acting.
Oregon Health Authority : Oregon Health Plan (OHP) Appeals and Hearings : Oregon Health Plan : State of Oregon · publisher html snapshot
Captured evidence SHA-256: 53893a3be1b17ef4c3bc1293fdc0fc0006a1a1efc8005d89731074431e3ff8a3
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