July 29, 2019
Starting Aug. 1 the Oregon Health Authority (OHA) will convene a series of advisory committees that will help develop the updated Oregon Administrative Rules (OARs) that govern Oregon's coordinated care organizations (CCOs) effective Jan. 1, 2020. These rules are part of the next phase of Oregon’s health care transformation known as “CCO 2.0.”
The draft rules:
- Align with the 2020-2024 coordinated care organization contracts.
- Incorporate CCO 2.0 policy recommendations adopted by the Oregon Health Policy Board to improve the health of Oregon Health Plan members, address health disparities, control program costs, and continue Oregon’s health care delivery transformation.
- Include expanded CCO financial reporting requirements.
- Feature new rules outlining CCO responsibilities regarding traditional health workers, social determinants of health, and health equity.
Oregon first established CCOs in 2012 to transform health care delivery in the state. CCOs bring together physical, behavioral, and oral health providers to coordinate care for people on the Oregon Health Plan. They improve health and reduce costs by providing more coordinated, flexible and innovative services. CCOs are rewarded for achieving specific health outcomes and quality measures. Nearly 87 percent of Oregon’s 1 million OHP members are enrolled in CCOs.
When:
- Aug. 1, 9 a.m. to noon: Social determinants of health and equity.
- Aug. 6, 9 a.m. to noon: Draft core structural rules OAR 410-141-3500, definitions) through 3545, SUD certification and licensure).
- Aug. 6, 1-4 p.m.: Draft core structural rules OAR 410-141-3550, dispute resolution) through 3700, CCO application and contracting procedures).
- Aug. 7, 9 a.m. to noon: Draft core structural rules OAR 410-141-3705, criteria for CCOs) through 3825, excluded services and limitations).
- Aug. 7, 1-4 p.m.: Draft core structural rules OAR 410-141-3830, Prioritized List of Health Services) through 3855, preferred drug list).
- Aug. 8, 9 a.m. to noon: Traditional health workers.
- Aug. 8, 1-4 p.m.: Financial reporting.
- Aug. 13, 9:30-11:30 a.m.: Care coordination rules.
- Aug. 14, 9:30-11:30 a.m.: Draft core structural rules on grievances and appeals.
- Aug. 14, 1:30-3:30 p.m.: Draft core structural rules on non-emergency medical transportation.
- Aug. 15, 9:30 a.m. to noon: Financial reporting.
- Aug. 15, 1-4 p.m.: Social determinants of health.
- Aug. 22, 1:30-3:30 p.m.: Financial reporting.
RAC meeting information: At each meeting, members will learn background information and purpose of the RAC, review the rulemaking process, review draft amended rule language and discuss next steps. Each meeting will include time for public comment at the end. Find agendas and call-in information and double-check the location of the meetings in advance of each meeting on the RAC website.
Where: Barbara Roberts Human Services Building Room 137A-D, 500 Summer St. NE, Salem.
Who: OHA is recruiting for CCO 2.0 RACs to include representation from key stakeholders and interested parties. Learn how to request to participate in the RACs on the committee website by July 31.
Program contact: Health Systems Division at cco2.0rulemaking@dhsoha.state.or.us.
Once the committees have given input on the draft rules, OHA will file notices of proposed rulemaking with the intent to file the rules effective Jan. 1. To keep informed during the remainder of the rulemaking process, sign up for updates on the Oregon Health Plan website.
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