Oregon Medicaid Managed Care Programs

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Oregon Medicaid Managed Care Programs

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Managed Care in OregonMedicaid


This profile reflects state managed care program information as of August 2014,
and only includes information on active federal operating authorities, and as such
, the program start date may not reflect the earliest date that a program enrolled
beneficiaries and provided services. Some states report populations and services

Medicaid Managed Care Enrollment and Program … – Medicaid.gov


Mar 31, 2016 37,411,965 to 34,969,949, with virtually all of the decrease due to corrections for
Oregon and Tennessee. • PCCM enrollment changed from 7,985,819 to
7,790,431. • BHO enrollment changed from 11,312,493 to 10,652,068. Table 2:
Medicare-Medicaid Eligibles ("Duals") Enrolled in Managed Care, as.

CMS Managed Care Final Rule Implementation Status – Oregon.gov


Nov 14, 2017 About the CMS 2390-F Managed Care Final Rule Implementation Project. The
project … required Oregon Administrative Rule (OAR) and coordinated care
organization (CCO) contract changes. … The project plan will ensure that OHA
updates the Oregon's Medicaid and CHIP State Plans; Section.

Coordinated Care OrganizationsOregon.gov


Oct 9, 2012 Right now, most Oregon Health Plan (Medicaid) members are moving into
Coordinated Care … CCOs will have more flexibility to provide services than
many managed care plans had before. This … Under managed care, OHP clients
may have one health plan for physical health, one for mental health,.

CMS Managed Care Final Rule Implementation Status – Oregon.gov


6 days ago About the CMS 2390-F Managed Care Final Rule Implementation Project. The
project … On December 28, 2017, OHA submitted required Oregon Administrative
Rule changes for final filing with Secretary … The project plan will ensure that
OHA updates the Oregon's Medicaid and CHIP State Plans; Section.

Facts about managed care organization drug rebates.pdf – Oregon.gov


Medicaid Drug Rebate Invoicing for Managed Care Prescriptions and Physician-
Administered Drug Claims (02/11). Date: February 4, 2011. Contact: DMAP
Pharmacy Program, dmap.rxquestions@state.or.us. Since 1991, outpatient
Medicaid pharmacy providers have billed fee-for-service prescriptions using
National Drug …

Department of Health and Human Services, Centers for … – CMS.gov


state level; and program integrity activities conducted by Oregon's Coordinated
Care. Organizations (CCOs). CCOs are managed health care delivery models
that provide, arrange, or subcontract for comprehensive medical services to 95%
of all Medicaid beneficiaries in Oregon. At the time of the review, there were 17 …

Medicaid Health Homes in Oregon – Office of The Assistant …


Sep 21, 2012 4. Oregon has approximately 645,000 people enrolled in its Medicaid program (
known as the Oregon. Health Plan [OHP]), which it has operated under a
Medicaid Section 1115 waiver. (described below) since 1993. 4,5. The state
managed care program covers approximately 80% of OHP beneficiaries.

Oregon Did Not Bill Manufacturers for Rebates for … – OIG .HHS .gov


ORGANIZATIONS. Gloria L. Jarmon. Deputy Inspector General for Audit Services.
March 2015. A-09-13-02037.

Medicaid Delivery System and Payment Reform – Kaiser Family …


Oct 22, 2013 Increasingly, state Medicaid programs have been expanding their use of
managed care as well as other service delivery and payment systems, as an ….
Medicaid ACO initiatives, such as Coordinated Care Organizations (CCOs) in
Oregon and Regional Care. Collaborative Organizations (RCCOs) in …

Program of All-Inclusive Care for the Elderly (PACE)


expands Medicaid eligibility. The Oregon Health Plan relies substantially upon a
prioritization of health services and managed care to achieve the policy
objectives of access, cost containment, efficacy, and cost effectiveness in the
allocation of health resources. (34) PACE — The Program of all Inclusive Care for
the Elderly …

Comparing Managed Care and Fee-For-Service – Missouri …


Jun 16, 2015 Retroactive Eligibility and the first 15 days allowed for MC plan enrollment. ▻
Special health care needs opt out population. ▻ Specialty Behavioral Health
Services – CPR, CSTAR, TCM. ▻ Pharmacy and Transplants. ▻ MHD
Administrative and IT services supporting MC contracting and payments. 8 …

State of Georgia Department of Community Health p y


Jan 17, 2012 of its Medicaid program, including PeachCare for Kids®, Georgia's Department of
Community. Health (DCH) is … a limited fashion in traditional Medicaid managed
care programs, the vast majority of these tools ….. Oregon: Oregon will be the first
state in the nation to develop a Medicaid Care. Coordination …

Comprehensive Study on Health Care and Health Care Costs in …


Administration, federal employee plans and other health care programs. …. The
percentage of Medicaid beneficiaries enrolled in managed care plans increased
….. Oregon. A push for increased access to health insurance for uninsured
Oregonians began in the late 1980s. Taking health care issues to Oregon
residents …

The Oregon Health Plan: An historical overview – Society for …


Jul 4, 2006 The Oregon Health Plan (OHP) is a public and private partnership to ensure
access to health care for all …. The Oregon Health Plan (OHP) formed in
response to conditions that threatened the social ….. Legislature establishes
Medicaid managed care plan and hospital provider taxes (HB 2747) to begin in …

Value Based Payment Arrangements Involving Risk Sharing


Oregon began a Medicaid Redesign Program in 2012 which will end in 2017. A
main feature of the Oregon. Medicaid Demonstration (2012) is the transition in
organizational structure from Oregon's traditional. Managed Care Organizations (
MCO) to Coordinated Care Organizations (CCO). A CCO is an MCO that is.

Health Data Systems Report – Nebraska Legislature


Oct 7, 2016 o Request for Proposal for Contractual Services, RFP Number 5151Z for the
purpose of selecting a qualified Contractor to provide full-risk, capitated Medicaid
managed care program for physical health, behavioral health, and pharmacy
services.3 Released on. October 21, 2015. Contracts were awarded …

nursing home survey report – State of Michigan


Apr 1, 2012 and/or IME payments under their state's Disproportionate Share Hospital (DSH)
program. In Oregon, major teaching hospitals are eligible to receive additional
payments intended to compensate them for their inability to capture DGME and/or
IME costs when contracting with Medicaid managed care plans.