Material Submission and Review
Managed Care Entities (MCEs) must submit member notices, informational and educational materials, and marketing materials to OHA for review and approval by the Quality Assurance & Contract Oversight unit prior to use and distribution to members.
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For more information about this Contract requirement, please see
Exhibit B, Part 3, Section 4 (f) in the 2023 CCO Contract.
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OHA uses a Microsoft PowerApp site to track material submissions and approvals.
Submission guidance for member materials
Language, nondiscrimination, and formatting
Readability
Readability of member documents should be Grade 6 on the Flesch-Kincaid Grade Level scale.
- Grade range: 6.0 to 6.9
- Preferred scoring method: Microsoft Word readability analysis
Learn more about what we exclude during readability reviews in the
Readability Scoring Guide
Language access and translation
All Oregon Health Plan member materials must include Language Access Statements, also called taglines, to ensure members know who to call to get materials in alternate formats, non-English languages, interpreters, and access other assistance. Taglines must be included within the body of a notice and must be at least 18 pt font. This requirement is outlined in OAR 410-141-3585 (5) (a) and 45 CFR 92.11.
MCEs must send materials in a member’s preferred language for all prevalent, non-English languages in the service area. For all other languages, translations must be provided when a member request is received.
"Prevalent, non-English language" is defined in OAR 410-141-3575 (1) (h) as the lesser of 5% of the MCE's total enrollment or 1,000 members.
Nondiscrimination statement
Per Section 1557 of the Patient Protection and Affordable Care Act, notice of nondiscrimination must be provided:
- To all enrollees on an annual basis;
- Upon request;
- At a conspicuous location on the CCO's website;
- In prominent physical locations, in no smaller than 20-pt sans serif font.
See federal requirements in 45 CFR 92.10. Nondiscrimination statement content requirements are outlined in CCO Welcome Packet and Annual Letter Evaluation Criteria.
Fonts
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Minimum font size for member materials: 12 point for regular text, 18 point for large text. Language Access Statements must be in at least 18 point. This requirement applies to all text, including headers, footers, and graphics.
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Preferred font type: Sans serif standard typeface, including Arial, Verdana, and Tahoma. Condensed font is not preferred because narrow setwidths are difficult to read.
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Color: The color contrast ratio must be at least 4.5:1 for regular text and 3:1 for large text. Check your font colors with
WebAIM Contrast Checker.
Member materials frequently asked questions
Please see the entries below for answers to our most frequently asked questions.
Text, emails, robocalls
Managed Care Entities (MCEs) may use text messaging or email to reach out to members, as long as plans adhere to Health Insurance Portability and Accountability Act (HIPAA) and Telephone Consumer Protect Act (TCPA) rules and guidelines. Each organization should check in with its own legal team.
Mass texts and emails need to follow the regular MCE Member Materials review process. Please check in with your materials coordinator for more information about this process.
Enrollment outreach for the Public Health Emergency Unwinding - 2023
On January 23, 2023, the
the Federal Communications Commission (FCC) ruled that it will allow robocalls and robotexts about post-PHE enrollment. 
Read the FCC's declaratory ruling.
FCC clarification on non-telemarketing healthcare calls - 2015
The Federal Communications Commission (FCC) issued a Declaratory Ruling and Order on July 10, 2015 which included the following guidance for non-telemarketing healthcare calls and texts:
Voice calls and text messages must be sent, if at all, only to the wireless telephone number provided by the patient;
Voice calls and text messages must state the name and contact information of the healthcare provider (for voice calls, these disclosures would need to be made at the beginning of the call);
Voice calls and text messages are strictly limited to the purposes permitted in [listed below]; must not include any telemarketing, solicitation, or advertising; may not include accounting, billing, debt-collection, or other financial content; and must comply with HIPAA privacy rules;
Restricted [to calls and text messages] for which there is exigency and that have a healthcare treatment purpose, specifically: appointment and exam confirmations and reminders, wellness checkups, hospital pre-registration instructions, pre-operative instructions, lab results, post-discharge follow-up intended to prevent readmission, prescription notifications, and home healthcare instructions.
Voice calls and text messages must be concise, generally one minute or less in length for voice calls and 160 characters or less in length for text messages;
A healthcare provider may initiate only one message (whether by voice call or text message) per day, up to a maximum of three voice calls or text messages combined per week from a specific healthcare provider;
A healthcare provider must offer recipients within each message an easy means to opt out of future such messages, voice calls that could be answered by a live person must include an automated, interactive voice- and/or key press-activated opt-out mechanism that enables the call recipient to make an opt-out request prior to terminating the call, voice calls that could be answered by an answering machine or voice mail service must include a toll-free number that the consumer can call to opt out of future healthcare calls, text messages must inform recipients of the ability to opt out by replying “STOP,” which will be the exclusive means by which consumers may opt out of such messages; and,
A healthcare provider must honor the opt-out requests immediately.
The information above applies to robocalls and texts to wireless numbers only if they are not charged to the recipient, including not being counted against any plan limits that apply to the recipient (e.g., number of voice minutes, number of text messages).
Please see the Telephone Consumer Protection Act (TCPA) Omnibus Declaratory Ruling and Order for more information.
Reminder:
Each organization should check in with its own legal team about HIPAA and TCPA requirements.
Taglines
All Oregon Health Plan member materials must include Language Access Statements, also called taglines, to ensure members know who to call to get materials in alternate formats, non-English languages, interpreters, and access other assistance.
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All language access statements (also called taglines) must include the following information: Availability of interpreters, non-English languages, accessible formats, and help at no cost; TTY/TDD number; Customer service number. See example taglines.
- For all member materials, CCOs must include statements in English and all prevalent non-English languages in the service area.
- Per Section 1557 of the Affordable Care Act, some member materials must include language access statements in Oregon’s Top 15 prevalent non-English languages. For the list of these materials, please see 45 CFR § 92.11.
- OHA uses the Monthly Medicaid Demographic Report to determine which languages fall into the Top 15 list.
Does a document that's been translated still need taglines?
Yes, you would need to include taglines in all of the prevalent languages in the service area, regardless of what language the document is in.
The intention of the tagline is that someone can still figure out who to call for help if they don’t speak the language of the overall document or if they need a different format.
For example: If a member’s preferred language is Vietnamese but they received a document in Russian by mistake, they could use the Vietnamese tagline to know who to call for help.
Does a postcard still need taglines?
Postcards still need a language access statement in 18 pt font. Because space is limited, the expectation is including at least one tagline in the same language as the document.
Readability
Readability of member documents should be Grade 6 on the Flesch-Kincaid Grade Level scale.
- Grade range is 6.0 to 6.9
- Preferred scoring method: Microsoft Word readability analysis
- References: OAR 410-141-3580 (6) (c); 42 CFR § 438.10
Tips for reducing readability scores
✓ Use active voice.
✓ Talk about one idea per sentence.
✓ Use short words and short sentences.
✓ Avoid jargon and acronyms.
✓ Add punctuation to lists and headlines.
Learn more about what we exclude during readability reviews in the Readability Scoring Guide.
Readability tools and resources
Word choice tools:
Plain language references and training:
Document submissions
Do I need to submit every document for OHA approval?
No. OHA has provided Submission Guidance to clarify what types of documents need to be reviewed.
Do I need to resubmit a document that was already approved?
It depends on how long it's been since approval.
No resubmission needed
- Document was approved within last 12 months.
- Contact information or date changes; minor formatting changes.
Resubmission needed
- Document was approved more than 12 months ago.
- There were changes to the document's messaging.
Will OHA assign an approval number for documents?
OHA tracking numbers were retired in 2020 as we moved to using automatically generated system ID numbers. Some CCOs continue to use their own tracking numbers.
- You are welcome to use whatever method works best for your team.
- OHA will continue to use the automated system ID number to reference documents.
Account or login help
OHA uses a PowerApps site to track documents and issue approvalsCCO Contract Deliverables Portal **Requires login credentials**How do I request permission for a new employee?
Please use the Account Requests form.
Who do I contact if I have trouble logging into my account?
Please call the DHS-OHA Service Desk at 503-945-5623 for help with password issues and login errors. HSD Quality Assurance staff cannot reset your password.
Formatting
Should I use brackets or carets to note variable data?
You can use either symbol. Both are acceptable for our review process, as most variable data fall into our list of readability exclusions.
Can I use a smaller font size if it's the equivalent to 12 pt in size?
No, all font sizes must be at least 12 pt, regardless of type or style, unless you receive an exception from the Materials Coordinator.
What is the preferred font type?
Sans serif standard typeface, including Arial, Verdana, and Tahoma. Condensed font is not preferred because narrow setwidths are difficult to read.
What are the color contrast requirements and how do I check?
The color contrast ratio must be at least 4.5:1 for regular text and 3:1 for large text. Check your font colors with WebAIM Contrast Checker.
Marketing
Marketing to CCO members or potential members
OHA must review communications when:
- They are intended to compel or entice a client’s enrollment in a CCO or associated QHP.
- The client is not a member of the CCO. This includes potential members and members who are no longer eligible.
- The provider is an employee, network provider, agent, or contractor of the CCO.
Examples of material subject to OHA review
If a CCO or provider used these phrases in material to clients not enrolled in the CCO, OHA would need to approve the material before it could be shared with the client/potential member.
- “Choose CCO Y so you can get your care with Provider X.”
- “Provider X will continue to provide you care if you select CCO Y.”
- “OHP members must select CCO Y to be able to see Provider X.”
Permitted communications
State rules permit communications to create name recognition; and to express participation in or support for a CCO by the CCO’s subcontractors or founding organizations, as long as they do not attempt to attract, urge, pressure, or otherwise entice or compel a member to enroll in a CCO.
Examples of permissible communications about CCO/provider affiliations
- “Provider X is contracted with CCO Y.”
- “CCO Y members may choose Provider X as their Primary Care Provider/Home.”
- “Provider X looks forward to serving CCO Y members” or “CCO Y and Provider X look forward to serving Oregon Health Plan members.”
Marketing commercial plans to members who are no longer eligible for CCOs
For members who are no longer eligible for OHP, we encourage CCOs to share information with members about their associated QHPs or Medicare Advantage plans. If a CCO chooses to do so, they must adhere to the following:
- CCOs are not permitted to share member data with commercial plans.
- CCOs are not permitted to instruct members to enroll or imply members must enroll in the associated commercial plan.
- Any communications to members who are no longer eligible for OHP must be generated by CCOs.
- Communications must meet all MCE marketing and information requirements.
- Communications must be submitted and approved via the regular Member Material Review process.
CMS Guidance:
Strategic Approaches to Engaging Managed Care Plans to Maximize Continuity of Coverage as States Resume Normal Eligibility and Enrollment Operations