Challenges brought to light by more than 80 Oregon Health Plan (OHP / Medicaid) members have helped reduce barriers to obtain medically necessary motorized wheelchairs and other durable medical equipment. OHP members alerted OHA of the issues by reaching out to OHA’s Ombuds Program staff, who make sure members on Oregon’s Medicaid program receive they care they need.  

In recent years, the Ombuds Program has received an increase in inquiries from OHP members who had difficulty getting coverage for durable medical equipment or DME. Wheelchairs, prosthetic limbs, blood sugar monitors and other tools that help people maximize their independence while living with health conditions are all examples of DME.  

Ombuds case workers partnered with the Oregon Department of Human Services, Oregon Disability Commission and others to organize a group called the DME Think Tank. The group – which included 12 OHP members as well as caregivers, providers and advocacy groups – shared their personal experiences with OHA Medicaid policy and program staff. 

One member of the DME Think Tank was a young man who became paralyzed after an accident. The report shares that he “felt dehumanized by the year-long struggle to get a mobility device that enabled him to do something as simple as navigate from his bed to the bathroom.”  

After hearing these and other stories, OHA Medicaid staff committed to making improvements by clarifying policies, improving coverage of DME through regulatory rulemaking and increasing oversight.  

Since being established, OHA’s Ombuds Program has responded to more than 8,708 Medicaid concerns. You can read more about the help provided by the program in their 2024 report. 

How to reach Ombuds 

OHP members who encounter barriers to receiving care are encouraged to first work directly with their coordinated care organization (CCO) to resolve any concerns. OHP members who are not able to receive the support they need from OHA or their CCO can contact the Ombuds Program by sending an email to OHA.OmbudsOffice@odhsoha.oregon.gov or calling 1-877-642-0450. The program’s phone message line is available in 14 languages. More information is on the OHA Ombuds program website.