OAR 410-136-3010
Coordinated Care Organizations
(1)
The Authority contracts with Coordinated Care Organizations (CCOs) to provide medical services for individuals receiving Division of Medical Assistance Programs (Division), Title XIX and Title XXI services for the purpose of providing integrated and coordinated care services across physical health, dental health, and non-emergent medical transportation (NEMT). See also OAR chapter 410, division 120 (General Rules) and division 141 (Oregon Health Plan rules) for definitions and responsibilities and OAR 410-120-1210 (Medical Assistance Benefit Packages and Delivery System)(4) (Division of Medical Assistance Programs and Delivery Systems) for a description of how individuals receive services through CCOs.(2)
When the Authority provides a CCO with a global budget that includes funds to provide NEMT services for its members, the CCO shall provide NEMT services to its members.(3)
The Authority may not pay for services a CCO covers for its members. Reimbursement is a matter between the CCO and its transportation providers.(4)
For members enrolled in a CCO, all transportation services must be coordinated through the member’s CCO or the CCO’s designated transportation provider, if any, prior to receiving services.
Source:
Rule 410-136-3010 — Coordinated Care Organizations, https://secure.sos.state.or.us/oard/view.action?ruleNumber=410-136-3010.