OAR 409-065-0015
Data Submission Requirements

(1) For the initial year of submission, 2021, all mandatory reporters, as identified in OAR 409-065-0110, must submit a completed Cost Growth Target Data Submission Template (CGT-1) to the Authority by Oct 1, 2021. Annual submission dates thereafter must be provided in the Cost Growth Target Data Specification Manual (CGT-2).
(2) CGT-1 must be submitted in accordance with instructions published by the Authority in the Cost Growth Target Data Specification Manual (CGT-2).
(3) Mandatory and voluntary reporters must submit data files for all required lines of business as defined in the Cost Growth Target Data Specification Manual (CGT-2). They may submit data files for the voluntary lines of business and may not submit data files for any excluded lines of business.
(a) Required lines of business include:
(A) Commercial;
(B) Medicare;
(C) Medicaid.
(b) Excluded lines of business include:
(A) Accident policy;
(B) Disability policy;
(C) Hospital indemnity policy;
(D) Long-term care insurance;
(E) Medicare supplemental insurance;
(F) Stand-alone prescription drug plans;
(G) Specific disease policy;
(H) Stop-loss plans;
(I) Supplemental insurance that pays deductibles, copays or coinsurance;
(J) Vision-only insurance;
(K) Workers compensation; and
(L) Dental-only insurance.
(c) A mandatory reporter that contracts with another entity remains responsible for reporting all required lines of business. If the mandatory reporter elects to have the data reported by a contracted entity, the mandatory reporter must notify the Authority and provide contact information for the contracted entity.
(4) The Authority has 90 calendar days to review and request clarification or corrections to the annual data submission (CGT-1). If the Authority finds errors through edit checks or validation, mandatory reporters must make corrections and resubmit data or submit a waiver request within 30 calendar days of notification by the Authority of the error(s) . The Authority may make multiple requests for corrections or resubmissions. The annual data submission is only considered complete when all corrections and resubmissions have been submitted and approved by the Authority.
(5) If a mandatory reporter changes its health risk adjustment method or software (including version updates), it must re-submit at least one prior year of data using the updated adjustment method in order to ensure comparability between years.

Source: Rule 409-065-0015 — Data Submission Requirements, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=409-065-0015.

Last Updated

Jun. 8, 2021

Rule 409-065-0015’s source at or​.us