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Oregon - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

Oregon covers Tenancy Support Services under the Health-Related Social Needs (HRSN) housing benefit authorized by its 1115 Medicaid Demonstration Waiver. The Oregon Health Authority (OHA) administers this benefit, requiring organizations to enroll as Medicaid providers via the MMIS Provider Portal and subsequently secure contracts with regional Coordinated Care Organizations (CCOs) that manage the benefit for over 90 percent of Oregon Health Plan (OHP) members.

Approval requires submitting the OHP 3113 and OHA 3975 forms for baseline fee-for-service enrollment, followed by network credentialing with the specific CCOs operating in the provider's service area. Providers must demonstrate the capacity to deliver pre-tenancy and tenancy sustaining supports without requiring a distinct state facility license, as this is an unlicensed community-based service governed by CCO network adequacy and OHA provider enrollment rules.

1. Service Definition and Scope

In Oregon, Housing Stabilization is defined under the 1115 Waiver's Health-Related Social Needs (HRSN) framework as Tenancy Support Services. This service is bifurcated into pre-tenancy supports, which assist members in finding and applying for housing, and tenancy sustaining supports, which focus on eviction prevention and landlord mediation.

The service is designed to assist individuals experiencing homelessness or housing instability who meet specific clinical and social risk criteria. It does not cover room and board, rent, or capital costs, but rather the administrative and interpersonal supports necessary to secure and maintain a lease.

2. Regulatory and Oversight Agencies

The Oregon Health Authority (OHA) Health Systems Division is the primary state agency responsible for Medicaid provider enrollment and the overarching administration of the 1115 Waiver HRSN benefits. OHA establishes the baseline qualifications and processes the initial OHP provider enrollment applications.

Day-to-day oversight, authorization, and network management are delegated to regional Coordinated Care Organizations (CCOs). Providers must interact with both OHA for baseline enrollment and individual CCOs for contracting and claims submission.

3. Gatekeeping Prerequisites: Who Can Even Apply

Oregon does not require a specific state-issued facility or agency license to provide HRSN Tenancy Support Services. However, the structural precondition for delivering this service is Coordinated Care Organization (CCO) network contracting. Because over 90 percent of OHP members are enrolled in CCOs, a provider cannot effectively operate or bill for this service without being accepted into the provider network of the CCO(s) governing their geographic region.

CCOs may restrict network entry based on regional network adequacy, meaning they can decline to contract with new providers if they determine they already have sufficient capacity for housing stabilization services. Providers must also be registered to do business in Oregon and possess a valid National Provider Identifier (NPI).

4. Licensure and Certification Requirements

Housing Stabilization and Tenancy Support under the HRSN benefit is an unlicensed service in Oregon. The state does not issue a specific "Housing Provider License" or "Tenancy Support Certificate." Instead, approval is based entirely on Medicaid provider enrollment and CCO credentialing standards.

Providers must adhere to OAR 410-120-1260 (Provider Enrollment) and ensure their business operations comply with local municipal business licenses and state corporate registry requirements.

5. Medicaid Provider Enrollment

To enroll as an OHP provider, organizations must submit specific forms to the OHA Provider Enrollment Unit. This can be done via the MMIS Provider Portal or by faxing the application using a mandatory EDMS coversheet. The primary forms required are the OHP 3113 and OHA 3975.

Providers must select the appropriate provider type and specialty code that aligns with HRSN community-based services. Failure to use the exact EDMS coversheet with the "Provider Enrollment" box checked will result in the faxed application being discarded by OHA.

6. Staffing, Training and Background Checks

While there is no state licensure dictating specific degrees for housing stabilization staff, personnel delivering HRSN services must meet CCO credentialing standards and pass state background checks. Staff typically include community health workers, housing navigators, or peer support specialists.

Agencies must ensure that all client-facing staff clear the Oregon Department of Human Services (ODHS) Background Check Unit (BCU) process to ensure they are not excluded from participating in federal healthcare programs.

7. Documentation, Policies and Records

Providers must maintain comprehensive records to support claims billed to CCOs or OHA. This includes documenting the member's housing risk factors, the specific pre-tenancy or tenancy sustaining interventions provided, and the time spent on each activity.

Records must align with the member's person-centered service plan and be retained in accordance with OAR 410-120-1360, which generally requires retention of Medicaid records for a minimum of seven years.

8. Billing, Rates and Claims

Because HRSN services are primarily managed by CCOs, billing and reimbursement rates are dictated by the specific CCO contracts rather than a single statewide fee-for-service schedule. Providers submit claims directly to the member's CCO using standard HCPCS codes designated for housing supports.

Prior authorization is frequently required by the CCO before tenancy support services can commence. Providers must verify member eligibility and CCO assignment via the MMIS Provider Portal before delivering services.

9. Approval Sequence and Timeline

The approval process begins with obtaining an NPI and registering the business with the Oregon Secretary of State. The provider then submits the OHP 3113 and OHA 3975 to the OHA Provider Enrollment Unit, which can take 30 to 60 days to process.

Once the OHA baseline enrollment is approved and an Oregon Medicaid Provider Number is issued, the provider must apply to join the network of the regional CCOs. CCO credentialing and contracting can add an additional 60 to 90 days to the timeline.

10. Common Denials and Survey Findings

A frequent cause for baseline enrollment denial or delay is the improper submission of faxed applications, specifically failing to use the mandatory EDMS coversheet or failing to check the "Provider Enrollment" box on that coversheet.

At the CCO level, the most common barrier is network adequacy denial, where a CCO refuses to offer a contract because they determine they already have enough housing stabilization providers in their region. Providers denied by a CCO can utilize the OHA Provider Discrimination Review process.

11. Key Contacts and Resources

The OHA Provider Enrollment Unit is the primary contact for baseline Medicaid enrollment questions and form submissions. They can be reached via email or phone for assistance with the MMIS portal.

For contracting and authorization, providers must contact the specific CCOs operating in their target counties. The NPPES registry is used for all NPI-related updates.

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