Who needs to "Pick a Plan" by November 17?
As you know, the Oregon Health Authority (OHA) is informing members in certain counties about the new CCOs coming to their area, and how to choose the coordinated care organization (CCO) that works best for them.
However, the following special populations will stay with their current plan. They will not need to choose a 2020 plan, unless their plan is closing and there is more than one plan choice in their area.
- Members who are dually eligible for Medicare and Medicaid
- Members enrolled in Office of Developmental Disability Services programs
- Children and youth enrolled in Child Welfare programs
- Children and youth enrolled in Oregon Youth Authority programs
Special populations who do need to make a 2020 plan choice by November 17 received this letter from OHA in October.
Communicating to patients about CCO affiliations
If you are notifying patients about the CCOs you network with, please:
- Keep the notice informational. ("Provider X works with CCO Y, but not CCO Z.")
- Do not include language that implies you are attempting to influence the patient's CCO choice. ("To keep getting care from Provider X, you must choose CCO Y.")
- If possible, only address patients who have been invited to participate in the "Pick Your Plan" member choice period through the October mailing.
To learn more, read OHA's fact sheet about marketing to OHP members. If in doubt about a patient communication related to your CCO affiliations, contact the CCO.
After December 31, 2019:
- PrimaryHealth of Josephine County will no longer serve Josephine, Jackson and Douglas counties.
- Willamette Valley Community Health (WVCH) will no longer serve Marion, Polk, Linn, Benton, Yamhill and Clackamas counties.
In November, OHA will inform PrimaryHealth and WVCH members of the closures and their new CCO for 2020.
If you serve PrimaryHealth or WVCH members:
Consider joining the new CCO network(s) or completing a single-case agreement with your patient's CCO in order to support continuity of care.
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To learn more, read about how to sign up for rulemaking notices.
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