OAR 409-027-0025
Coordinated Care Organization (CCO) Reporting Requirements

(1)

No later than October 1 of each year through 2027 each CCO shall submit all non-claims based primary care expenditures as defined in OAR 409-027-0020 for the prior calendar year’s data [Example: January 1, 2018 through December 31, 2018 data needs to be submitted by October 1, 2019] using the approved file layout and format available at: http:/­/­www.oregon.gov/­OHA/­HPA/­Pages/­Rulemaking.aspx.

(2)

No later than October 1 of each year through 2027 each CCO shall submit all non-claims based total health care expenditures as defined in OAR 409-027-0020 for the prior calendar year’s data [Example: January 1, 2018 through December 31, 2018 data needs to be submitted by October 1, 2019] using the approved file layout and format available at: http:/­/­www.oregon.gov/­OHA/­HPA/­Pages/­Rulemaking.aspx.

(3)

Each category included in the approved file format is mutually exclusive; therefore, expenditures shall only be accounted for in one category.

(4)

Claims-based primary care and total health care expenditures will be calculated for each CCO by the Authority using data from the Authority’s All-Payer All-Claims Database.

(5)

Expenditures for services or activities outside the primary care setting, regardless of a primary care capacity building intent, are not considered primary care expenditures for purposes of this report.
NOTE: Other CCO rules can be found at OAR 410-141-3000 to 410-141-3485.

Source: Rule 409-027-0025 — Coordinated Care Organization (CCO) Reporting Requirements, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=409-027-0025.

Last Updated

Jun. 8, 2021

Rule 409-027-0025’s source at or​.us