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CCO Quality Assurance

External Quality Review

The Oregon Health Authority contracts with an external quality review organization (EQRO) to perform external quality review of the Medicaid managed care services delivered to Oregon Health Plan members. These annual reports are listed below.

  
2013 EQR Technical Report
2014 EQR Technical Report
2015 EQR Technical Report
2016 EQR Technical Report
2017 EQR Technical Report
2018 EQR Technical Report

CCO evaluations

The Oregon Health Authority also requests other evaluations as needed to determine compliance with state and federal requirements.

  
2017 CCO Delivery Systems Network Capacity Report

Corrective Action Plans

When a CCO is found to be out of compliance with state or federal requirements, the Oregon Health Authority issues a notice of noncompliance. The CCO must develop and implement a corrective action plan to correct the issues outlined in the notice of noncompliance.

  • Health Share of Oregon: Initial notice related to non-emergent medical transportation services, issued October 14, 2019
  • Cascade Health Alliance: Initial notice related to Hepatitis C treatment, issued May 20, 2019; with recent findings issued August 27, 2019

 

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