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Oregon Health Plan (MCO and CCO) Program

 

Oregon Administrative Rules and supplemental information administered by the Health Systems Division.

 Receive program updates by text or email - Please specify which program(s) you are interested in; otherwise, you will receive updates for all programs.

Recent rule filings

You can also view all OHP (MCO and CCO) Program rules as filed with the Secretary of State.

Administrative rulebooks

Each rulebook is an interactive PDF that contains the program rules effective on the "Effective Date" listed for the rulebook.  If you need an older rulebook not listed here, visit the OHP Rulebooks page.

Financial rulebooks

The financial rulebooks contain the rules about OHA's financial oversight of coordinated care organizations (OARs 410-141-5000 through 5380).

Non-financial rulebooks

The non-financial rulebooks contain the rules that govern coordinated care organizations (OARs 410-141-3500 through 3965).

Repealed rulebooks

The rules in these rulebooks have been repealed effective January 1, 2020. For rulebooks of current rules, please refer to the Financial and Non-Financial rulebooks listed above.

Supplemental information and guidelines

Also visit the OHP Tools for Health Plans, Managed Care Tax Rules and Forms, and Prioritized List of Health Services websites.

Guidelines

Drug Carve Out

Hospital Reimbursement

Fee-for-service DRG and Type A/B rates

Visit the Hospital Services policy page.

Type A/B hospital reimbursement

Forms

Also see the CCO Contract Forms page for forms and material related to contract deliverables.

Policy Quick Links

Rule and guidelines by program

Temporary rules

Notices of Proposed Rulemaking

OHP Rulebooks

Who to call for help

Provider Services

 800-336-6016 or  email us

 Address and telephone contacts

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