If you have OHP (Medicaid) or cash benefits (TANF)
- If you have Oregon Health Plan (OHP) or Temporary Assistance for Needy Families (TANF), you must report accidents or injuries that are caused by another liable person or business. This includes car accidents and work-related injuries.
- This is so we can make sure the person or business that is liable for your injuries reimburses the State of Oregon for any medical expenses paid on your behalf.
- If you are applying for OHP or TANF and have a personal injury claim that isn't settled, or are being treated for an injury, you must report the injury.
Report an injury
People who have OHP and TANF, attorneys, insurance adjusters, Coordinated Care Organizations (CCOs) and ODHS/OHA staff can all report injuries. If you can't make a report, we can make one for you.
Report an injury
Need help to make a report? Contact us
If you have OHP or TANF: You can also contact your caseworker or call ONE Customer Service at 800-699-9075.
Attorneys, adjusters and CCOs:
Review these tips for making a report (PDF)
Frequently asked questions
You can call the ONE Customer Service Center at 800-699-9075 or connect with your
local ODHS office to check.
It is required by Federal and
State law.
This is so we can make sure the person or business that is liable for your injury reimburses the State of Oregon for any medical expenses paid on your behalf.
If you receive OHP or TANF benefits and don't report a personal injury caused by another person or business, you risk losing those benefits. You might also be personally liable for the money the State of Oregon would have been able to collect from the responsible person or business.
Yes. If you are applying for OHP or TANF benefits, you must make a report if:
- You have a personal injury claim that has not been settled, or
- You are still being treated for the injury
You don't have to make a report if all claims from the injury have been settled before you apply.
Yes. If the person who has OHP or TANF can't make a report, their representative (which could be a parent or another person) can report for them.
Your caseworker can submit the report for you.
To prevent any potential issues, you should check with your caseworker to make sure they are going to do this for you.
If PIL needs more information after the report is submitted, we will contact the person who made the report.
PIL will determine if there is a claim against a liable third party as a result of the accident. We may file a lien on any settlements or court judgments to make sure the State is reimbursed for medical expenses it paid on your behalf.
They might. Most car insurance policies include Personal Injury Protection (PIP) coverage that requires them to pay any medical expenses before OHP (Medicaid). You should contact your insurance company with questions about insurance coverage.
Also, your Uninsured Motorist or Underinsured Motorist Coverage may be liable to pay for some or all the expenses of your injury. Depending on your case, the State may seek reimbursement from them.
Your car insurance coverage may run out. If it does, the State may pay claims for health services that are covered by OHP (Medicaid). PIL needs to make sure the State can be reimbursed from the liable party if necessary.
We recommend that you
contact your insurance company to be sure, but usually, claims against Personal Injury Protection don't make premiums go up. Claims against your Uninsured Motorist or Underinsured Motorist coverages may result in higher premiums if you are found to be partially at fault.
No. A CCO (Coordinated Care Organization) is not insurance. A CCO is an organization that contracts with the State to administer Oregon Medicaid benefits (OHP).
No. State law requires the Attorney General to represent the State and any agency of the State.
Yes. Both the CCO and the ODHS Personal Injury Liens unit must be notified of an injury. They may have each paid a claim for medical benefits. A lien placed by the State has priority over a CCO lien.
Any attorney who is practicing law in Oregon must follow state laws that require the attorney to report injuries of any OHP member who receives benefits from Oregon.
OHP members should confirm if their attorney reported the injury. If the attorney doesn't report the injury, the OHP member is required to report it to PIL.
Contact us