Or. Admin. Code § 410-115-0045
Current through Register Vol. 63, No. 11, November 1, 2024
Section 410-115-0045 - CCO Administration of OHP Bridge - Basic Health Program; OHP Bridge Enrollment and Choice of CCO(1) OHP Bridge - Basic Health Program shall be administered by Coordinated Care Organizations (CCOs) pursuant to an OHP Bridge - Basic Health Program CCO Contract entered into by each CCO and the state acting by and through the Authority.(2) The terms and conditions included in the OHP Bridge - Basic Health Program CCO Contract shall comply with all applicable state and federal laws, including, without limitation 42 USC 18051, 42 CFR Part 660, ORS 414.241 and 414.245, and OAR Chapter 410, Division 141. The rules set forth in this Division 115, OAR Chapter 410, Division 141, and the federal regulations set forth in 42 CFR Part 600.(3) Applicants determined by the Authority to be eligible for OHP Bridge - Basic Health Program shall be enrolled in a CCO. Enrollment and disenrollment from a CCO, including choice of CCO, shall be made in accordance with OAR 410-141-3805 and OAR 410-141-3810, except that: (a) Exceptions to mandatory managed care enrollment described in OAR 410-141-3805 (4 - 16) do not apply to OHP Bridge - Basic Health Program; and(b) OHP Bridge Basic Health Program members cannot be disenrolled from the OHP Bridge - Basic Health Program and be covered under the fee-for-service (FFS) delivery system under OAR 410-141-3810.Or. Admin. Code § 410-115-0045
DMAP 94-2024, adopt filed 05/29/2024, effective 6/1/2024Statutory/Other Authority: ORS 411.402, 411.404, 413.042, 414.241, 414.534, 42 CFR 600 & 600.300
Statutes/Other Implemented: ORS 411.402, 411.404, 414.241, 414.534, ORS 411.400, 411.406, 411.439, 411.443, 413.032, 413.038, 414.025, 414.231, 411.447, 414.536 & 414.706