Oregon Health Network Adequacy
Listing Websites about Oregon Health Network Adequacy
Oregon Health Authority : Network Adequacy - Time and …
(3 days ago) WebOregon has made changes to the network adequacy rules for OHP with a focus on standards for how long it should take most CCO members to get to different types of providers or services. These changes were made using considerable feedback from members, community partners, and health plans.
https://www.oregon.gov/oha/HSD/OHP/Pages/network.aspx
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OAR 410-141-3566 – Telehealth Svc. & Reimbursement …
(8 days ago) WebShould the Authority exercise options in this section (9), all CCO obligations for Network Adequacy requirements as described in OAR 410-141-3515 (Network Adequacy) remain in full effect. Administration of Oregon Integrated and Coordinated Health Care Delivery System Regulation 410–141–3505 Use of Subcontractors …
https://oregon.public.law/rules/oar_410-141-3566
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ORS 414.609 – Network adequacy - OregonLaws
(6 days ago) WebNetwork adequacy 414.611 Transfer of 500 or more members of coordinated care organization 414.613 Discrimination based on scope of practice prohibited 414.619 Coordination between Oregon Health Authority and Department of Human Services 414.628 Innovator agents 414.631 Mandatory enrollment in coordinated care …
https://oregon.public.law/statutes/ors_414.609
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Oregon Secretary of State Administrative Rules
(6 days ago) WebOREGON HEALTH PLAN 410-141-3515 Network Adequacy (1) MCEs shall maintain and monitor a network of participating providers that is sufficient in number, provider type, and geographic distribution to ensure adequate service capacity and availability to provide available and timely access to medically appropriate and culturally responsive covered
https://secure.sos.state.or.us/oard/viewSingleRule.action?ruleVrsnRsn=285396
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SB 1046 Network Adequacy - Oregon Legislative Assembly
(7 days ago) Web3. Access to reproductive health services. SB 1046 explicitly adds reproductive health services to the services that must be made accessible to all enrollees to clarify that this will be a focus of the department’s network adequacy oversight. 4. Provide the department with authority to set quantitative network adequacy standards.
https://olis.oregonlegislature.gov/liz/2023R1/Downloads/CommitteeMeetingDocument/265947
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OAR 836-053-0320 – Annual Report Requirements for Network …
(8 days ago) WebAnnual Report Requirements for Network Adequacy. (1) An insurer offering individual or small group health benefits plans must submit its annual report for each network required under ORS 743B.505 (Provider networks) no later than March 31 of each year. (2) Beginning March 31, 2020, the annual report shall include at least the following
https://oregon.public.law/rules/oar_836-053-0320
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Network Adequacy and Provider Directory Accuracy Policy Updates
(9 days ago) WebThe Oregon Health Authority (OHA) issued a proposed rule to amend network adequacy standards for Coordinated Care Organizations (CCOs) that manage Oregon Health Plans (OHPs) in the Medicaid and Children’s Health Insurance Program. The proposed rule expands network adequacy geographical designations, time and …
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SB 1046: Network Adequacy
(5 days ago) Web350 Winter St. NE, Rm 410, P.O. Box 14480, Salem, OR 97309 503-378-4140 dfr.oregon.gov 1 SB 1046: Network Adequacy Network adequacy refers to the ability of a health plan to provide enrollees with timely access to a sufficient number of in-network providers. In Oregon, the Department of Consumer and
https://olis.oregonlegislature.gov/liz/2023R1/Downloads/PublicTestimonyDocument/67141
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OAR 836-053-1190 – Annual Summary, Uniform Indicators of …
(8 days ago) WebWhether the insurer has a process for ensuring network adequacy that includes oversight, communication and monitoring, and the following information about the process: (A) Oregon Standard Bronze and Silver Health Benefit Plans for Plan Years 2014, 2015 and 2016 836‑053‑0011
https://oregon.public.law/rules/oar_836-053-1190
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Section 410-141-3515 - Network Adequacy, Or. Admin. R. 410
(6 days ago) WebSection 410-141-3515 - Network Adequacy (1) MCEs shall maintain and monitor a network of participating providers that is sufficient in number, provider type, and geographic distribution to ensure adequate service capacity and availability to provide available and timely access to medically appropriate and culturally responsive covered …
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Oregon Health Authority : CCO Quality Assurance : Oregon Health …
(2 days ago) WebThe Oregon Health Authority (OHA) agreed with the audit’s findings. As noted in the response, the agency has made changes to program oversight and through its CCO 2.0 contracts that address the audit’s compliance concerns. OHA works to develop Network Adequacy Standards that are in alignment with 42 CFR 438.68(c), 42 CFR 438.206 and …
https://www.oregon.gov/oha/HSD/OHP/Pages/CCO-QA.aspx
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Increasing Organ Transplant Access (IOTA) Model CMS
(4 days ago) WebThe proposed Increasing Organ Transplant Access Model aims to increase access to life-saving transplants for patients living with kidney disease and reduce Medicare expenditures. This model would focus on encouraging transplant hospitals to use more of the kidneys that become available for transplantation and facilitate more transplants from …
https://www.cms.gov/priorities/innovation/innovation-models/iota
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A Closer Look at the Access Provisions in Final Medicaid Managed …
(3 days ago) WebAs my colleague Leo Cuello has explained, the Centers for Medicare & Medicaid Services (CMS) has revised its regulations governing Medicaid managed care.One purpose of this new Managed Care Rule is to improve access to health care for children, families, and other populations enrolled in Medicaid managed care organizations …
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OAR 836-053-0340 – Factor-Based Evidence of Compliance with …
(8 days ago) Web836–053–0000 Applicability of January 1, 2014 Amendments to OAR Chapter 836, Division 53 836–053–0001 Modification of Health Benefit Plan Not Subject to Level of Coverage Requirements 836–053–0002 Modification of a Health Benefit Plan Subject to Levels of Coverage Requirements 836–053–0003 Prohibition of Exclusion Period for Pregnancy …
https://oregon.public.law/rules/oar_836-053-0340
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