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1154 Chapter 7:Worker guides • Section 7: OSIPM worker guides (07/2026) name at the end of the year. If you receive such 1099, scan it into EDMS and shred the confidential document. For these care settings, ODHS|OHA continues to pay for the individual’s services, less any liability for the individual’s share. ODHS|OHA’s payment to the facility is not interrupted or delayed due to the LTC insurance payments. Once a payment has been turned over to ODHS|OHA, it is no longer counted as income. Long-term care insurance payments for nursing facility placements Individuals placed in nursing facilities must either designate the facility as the payee so that the facility will receive the LTC insurance payments directly, or turn any payments received by the individual or their representative over to the facility when they are received. It is the facility’s responsibility to adjust ODHS|OHA’s bill as payments are received. ODHS|OHA’s service payment to the facility may be denied or delayed due to the LTC insurance payments. If the individual’s MMIS record shows that LTC insurance payments are available, the facility’s claim will not be paid unless the claim shows a third-party resource adjustment or denial from the insurance provider. Long-term care partnership resource exclusion A Qualified Partnership Policy (QPP) is an LTC insurance policy that would afford extra benefits to individuals who utilize the LTC payments prior to applying for Medicaid. Having a QPP is an incentive for individuals to plan ahead and purchase LTC insurance. QPPs are transferable from state to state. That means if an individual purchased a QPP while the individual resided in another state and after the effective date for that state’s partnership program, the individual will receive the same benefits described in this worker guide as if the policy had been purchased in Oregon. Per 461-160-0855 the individual is eligible for a special resource exclusion in an amount equal to the amount of payments received under a QPP at application for Medicaid. The worker will be able to recognize a QPP issued in Oregon because the individual will receive a notice with their LTC policy stating that it is a QPP. The worker can verify the total payments a individual has received under a QPP issued in Oregon by the individual’s “explanation of benefits” (EOB). The EOB will verify the total payments to date from the Partnership Policy and if there are any benefits remaining. If the individual does not have their EOB, they can request a replacement from their insurance company. If a policy was issued in another state and the individual claims it is a QPP, the worker will need to verify with the other state that it is a QPP. The individual gets the same resource exclusion for an out-of-state QPP as they would get from a QPP purchased in Oregon, unless the QPP was purchased in California. For this state, there is no required reciprocity agreement, so the individual does not get any resource exclusion in Oregon. For out-of-state QPPs that qualify for resource exclusion, the EOB or other verification from the insurance company can be used to verify the total payments received too. The Insurance Division has also created a form that the individual can use to send to the LTC insurance company to verify QPP information. Contact the APD policy unit if you need help verifying this information with the other state.