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. This requirement is outlined in:
- Exhibit B, Pt 3, Sec 4
- OAR 410-141-3575, 410-141-3580, 410-141-3585
- 42 CFR 438.10
Member Material Review Timelines
- Regular submissions are reviewed within 45 days.
- Expedited submission are reviewed within 15 days. Criteria: Urgent needs that affect members, such as changes to provider networks.
- Emergency submissions are reviewed within 4 days. Criteria: Public health emergencies such as wildfires, floods, or any emergent needs.
Submission Guidance
Please note: All member materials, regardless of submission status, must comply with OAR, ORS, CFR, and Contract requirements.
Submission Needed:
- All Provider Termination materials, per 42 CFR 438.10(f)(1). This includes any letters, text
messages, phone scripts or other materials related to any contracted provider termination or
closure.
- Important: All provider terminations must be submitted, including the specific notice
that will be sent with provider detail. We are noting this as we most often receive
templates without specific information or templates only related to DSN Material
Changes.
- All Marketing materials, per 42 CFR 438.104(c). Please use the Marketing Checklist before
submitting your documents.
- Separate Contract Deliverables, including but not limited to:
- Member Handbooks
- Denial
notices
- Annual letters and Welcome Packets
- Notices of Nondiscrimination and Language
Access
- Health Risk Assessments
Materials not listed above do not need to be submitted to OHA for review, unless specifically
requested via Admin Notice.
Important: CCOs are still responsible for ensuring all materials meet compliance with state and federal
requirements, including language access taglines, accessibility, and readability requirements. OHA
recommends using the
Checklist for OHP Member Materials to review your materials internally.
- Reminder: Language Access taglines must be included in the Top 15 non-English languages in
Oregon if the material is called out in 45 CFR § 92.11.
Checklist for OHP Member Materials
Please refer to the
Checklist for OHP member materials.
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. "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.
- 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: 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.
- 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 CFR, OARs, and contract information.
How to Submit Materials for Review
OHA uses a PowerApps site to track documents and issue approvals
To request permission for a new employee:
Please use the
Account Requests form.
Please call the DHS-OHA Service Desk at 503-945-5623 for help with password issues and login errors. Quality Assurance staff cannot reset your password.
Marketing Materials
Marketing material by CCOs and their subcontractors (including providers or provider groups) is subject to review and approval by the Oregon /Health Authority (OHA). For more information, please see the
Marketing Materials Checklist.
Materials subject to review:
- They are intended to compel or entice a cleint's enrollment 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.
Examples:
If a CCO or provider uses these phrases in material to clients not enrolled in the CCO, OHA would need to approve the material.
- “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:
- “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."
Please see the entries below for answers to our most frequently asked questions.
If you have a question that is not listed below, please contact
CCOEngagementTeam@oha.oregon.gov.