Overview
Please be sure material submitted to Oregon Health Authority (OHA) for approval or attestation meet all member material requirements. For all requirements, refer to:
- Exhibit B, Part 3, Section 4 of your current contract with OHA
- Oregon Administrative Rules 410-141-3575, 410-3580 and 410-141-3585
- Federal member material requirements in 42 CFR 438.10
This page lists templates and resources to help CCOs meet these requirements.
Member Material Criteria and Templates
Notice templates are listed below. Also refer to these resources:
Checklist for OHP Member Materials
This checklist is provided as a quick reference. It does not replace the resources listed above.
The checklist is also available on page 3 of the
Member Materials Submission Guide.
Visit the main Quality Assurance Material Submission and Review page for more guidance.
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.
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.
Word choice tools:
Plain language references and training:
All Oregon Health Plan member materials must include Language Access Statements, also known as taglines, in all prevalent languages. Oregon Administrative Rule 410-141-3575 (1) (h) defines" Prevalent non-English language" as the lesser of 5% of the MCE's total enrollment or 1,000 members.
- 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. For materials not on this list, language access statements must be in English and all prevalent non-English languages in the CCO service area.
- OHA uses the OHP Medical Redeteriminations Dashboard to determine which languages fall into the Top 15 list.
Taglines must be included within the body of a notice and include:
- Help is free
- Other languages and formats are available
- Interpreters are available
- Customer service number
- TTY number
- Be in 18 pt font size
Resource: Translated language access statement / tagline examples are available for use in Oregon Health Plan materials.
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.
Preferred font type:
Sans serif standard typeface, including Arial, Verdana, and Tahoma. Condensed font is not preferred because narrow setwidths are difficult to read.
Color contrast:
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.
Links and QR codes
URLs and QR codes are correct.
Hyperlinks are working.
CCOs should ensure their member materials have CCO branding and contact information. In addition, subcontractor materials must be co-branded with the CCO.
The content should be accurate and reflect the most current information available. Please ensure materials are reviewed against current CFR, OARs, and contract information.
Marketing Material Requirements
Marketing material by CCOs or their subcontractors (including providers or provider groups) is subject to review and approval by OHA if the material:
- Is intended to compel or entice a client to enroll in a CCO,
- The client is not a member of the CCO, and
- The provider is an employee, network provider, agent, or contractor of the CCO.
For example, OHA would need to approve CCO or provider material that contained statements such as:
- “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."
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:
- “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."
Frequently Asked Questions
If you have a question not answered here, please contact CCOEngagementTeam@oha.oregon.gov.
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.
Enrollment outreach for the Public Health Emergency Unwinding - 2023
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 FCC issued a Declaratory Ruling and Order 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.
Please see the Telephone Consumer Protection Act (TCPA) Omnibus Declaratory Ruling and Order for more information.
No, because the requirement applies to any and all written member materials.
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.
OHA encourages CCOs to share information with members moving to Marketplace or Medicare coverage about their associated Qualified Health Plans or Medicare Advantage plans. If choosing to do so, CCOs must adhere to the following:
- Do not share member data with commercial plans.
- Do not instruct members to enroll or imply members must enroll in the CCO's commercial plan.
- Only the CCO may generate these communications.
- Ensure the communications meet all MCE marketing and information requirements.
- Submit all such communications for OHA approval using 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
Call, video and radio scripts do not require a language access statement.
Text messages require a link to a language access statement or a reference to contact information for the member to get language help.
Text, call, video, or radio scripts do not require specific font requirements.
Large-scale ads like billboards do not require specific font sizes or language access statements.
CMS templates do not undergo a review with OHA, but they should meet these requirements. Language access statements should be attached and documents should still meet 12-point font size requirements.
Postcards still need a language access statement in 18 point font size. Because space is limited, OHA's expectation is that CCOs include at least one tagline in the same language as the document.