Medical Assistance

ORS 414.654
Persons served by prepaid managed care health services organizations

  • funding of health information technology


(1)

(a) The Oregon Health Authority shall continue to contract with one or more prepaid managed care health services organizations, as defined in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414), that are in compliance with contractual obligations owed to the state or local government on July 27, 2015, and that serve:

(A)

A geographic area of the state that a coordinated care organization has not been certified to serve; or

(B)

Individuals described in ORS 414.631 (Mandatory enrollment in coordinated care organization) (2), (3) and (4).

(b)

Contracts authorized by this subsection are not subject to ORS chapters 279A and 279B, except ORS 279A.250 (Definitions for ORS 279A.250 to 279A.290) to 279A.290 (Miscellaneous receipts accounts) and 279B.235 (Condition concerning hours of labor).

(2)

Prepaid managed care health services organizations contracting with the authority under this section are subject to the applicable requirements for, and are permitted to exercise the rights of, coordinated care organizations under ORS 414.153 (Services provided by local health departments), 414.572 (Coordinated care organizations), 414.591 (Coordinated care organization contracts), 414.605 (Consumer and provider protections), 414.607 (Use and disclosure of member information), 414.638 (Metrics and scoring subcommittee), 414.655 (Utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations), 414.712 (Health services for certain eligible persons), 414.728 (Reimbursement of rural hospitals on fee-for-service basis), 414.743 (Payment to noncontracting hospital by coordinated care organization), 414.746, 414.760 (Payment for patient centered primary care home and behavioral health home services), 416.510 (Definitions for ORS 416.510 to 416.610) to 416.610 (Action against recipient who fails to provide notice of claim), 441.094 (Denial of emergency medical services because of inability to pay prohibited), 442.372 (Definitions for ORS 442.372 and 442.373), 655.515 (Benefits, training and medical services under ORS 655.505 to 655.555), 659.830 (Prohibitions and requirements relating to health insurance) and 743B.470 (Medicaid not considered in coverage eligibility determination).

(3)

To facilitate the full adoption of health information technology by coordinated care organizations, patient centered primary care homes and behavioral health homes, the authority shall explore options for assisting providers and coordinated care organizations in funding their use of health information technology. [2011 c.602 §14; 2012 c.8 §2; 2015 c.792 §1; 2015 c.798 §16]

Source

Last accessed
Jun. 26, 2021