OHA to host CCO 2.0 provider webinar on November 21, 2019
Get the latest information about CCO 2.0 and how to support Oregon Health Plan members during the transition to new coordinated care organizations (CCOs) in 2020. During the webinar, the Oregon Health Authority (OHA) will share information about:
- Next steps with member choice, CCO enrollment and CCO closures
- Continuity of care for members changing CCOs in 2020
- Engaging with CCOs about credentialing, billing and payment
Join us on Thursday, November 21, from 12 to 1 p.m. PDT. To register, submit questions and review the webinar agenda, go to: https://register.gotowebinar.com/register/8728900070139531788
Questions? Contact Maria Vargas, Regional Outreach Coordinator at maria.vargas@dhsoha.state.or.us.
Are 2020 CCO changes happening in your county?
Read OHA's new fact sheet that lists:
- The CCO changes happening in each Oregon county, and how members will transition to new CCOs in affected counties, and
- The counties that have no CCO changes for 2020.
We hope this resource helps providers understand how the changes affect them, and which CCOs to engage with to ensure continuity of care for patients moving to a new CCO in 2020.
Remember that not all OHP members will move to a new CCO. Special populations, such as Medicare-Medicaid members, will only change CCOs if their current CCO is closing. Learn more on OHA's CCO 2.0 provider resources page.
OHA’s fee-for-service prior authorization (PA) requirements provide technical and clinical support for a consistent and objective PA review process. Routine PA requests are processed within 3 calendar weeks of receipt of a complete and reviewable submission. To avoid delays in the review process, please be sure to:
For a full overview of OHA’s process and to learn how to submit web portal requests, you can watch the video or view the slides from OHA’s webinar about how to submit fee-for-service physical health PA requests.
OHA has updated its guide for billing the Oregon Health Plan for services provided to National Diabetes Prevention Program (DPP) participants. The changes align with recent Prioritized List of Health Services updates that permit DPP reimbursement for:
- Services delivered as an intervention for prediabetes (when confirmed via blood test within the past year) or previous gestational diabetes, according to line 3 of the Prioritized List of Health Services and as noted in Guideline Note 179, effective January 1, 2019; or
- Services delivered as a high intensity intervention for obesity or overweight diagnoses (according to line 320 of the Prioritized List and as noted in Guideline Note 5), effective October 1, 2019.
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