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Financial Recovery Financial recovery comprises several programs under the Office of Payment Accuracy and Recovery that help offset costs of human services by collecting money from individuals, the estates of people who received certain DHS services, institutions, and others. These groups assure program integrity by improving payment accuracy and recovery efforts throughout the Department. The Administration Section is responsible for providing leadership to DHS recovery efforts. The Administration Section takes the lead in championing IT system and process improvement efforts as well as coordinating business planning, business continuity, and the budget and legislative processes for the Office.
CMU works with Children, Adults and Families (CAF), Seniors and People with Disabilities (SPD), Child Welfare (CW), Oregon Youth Authority (OYA), Area Agencies on Aging (AAA), and the Division of Medical Assistance Programs (DMAP).in making changes/corrections to eligibility coding.
When a Medicaid or General Assistance client dies, we are required by law to recover money spent for care from the client's estate. The Estate Administration brochure (English or En Español ) contains important information about the recovery process.
Fraud Investigations Unit investigates allegations of fraud in DHS Self-Sufficiency programs. Learn more about fraud reporting and investigation at DHS.
Health Insurance The Health Insurance Group is responsible for verifying private health insurance information for Medicaid eligible clients. HIG works with DHS staff statewide, as well as insurance carriers, managed care providers and other state agencies.
Persons who receive care from the State's institutions are charged for that care based on their ability to pay. Recovery or collection of funds are used in support of the Institution's treatment programs.
Medical Payment Recovery The Medical Payment Recovery Unit is responsible for recovering Medicaid funds that have been expended where other insurance coverage should have been a primary resource. MPR works with insurance carriers, managed care providers, clients and other state agencies.
Overpayment Recovery Overpayment Recovery occurs when we've paid too much to clients or vendors of non-eligible cash, medical, food stamp or vendor payments.
The Overpayment Writing Unit (OWU) identifies and calculates overpaid benefits to DHS clients and child care providers. The goal is to assure that recipients of food stamps, medical, and other types of public assistance receive only the amount of benefits that they are actually eligible for.
Personal Injury Lien We use Personal Injury Lien claims or settlements for recovery of money owed to the state, when a client may be involved in a vehicle accident or a personal injury situation.
Policy and Data Match The Policy and Data Match Unit staff work with DHS staff statewide, as well as with federal regulators and other partners, in presenting training, developing policy, and working on a variety of data matches. It is the Policy and Data Match mission to provide training and data match results for internal and external partners; that will enhance payment accuracy, cost savings, and recovery.
The Provider Audit Unit is responsible for monitoring the integrity of provider payments made by the DHS. Our primary focus involves reviewing providers who submit fee-for-service claims to the Oregon Health Plan. Learn more about provider fraud reporting and investigation at DHS.
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