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Dental care organizations (DCOs) are prepaid managed care organizations that contract, on a capitated basis, with OHA. Currently there are five contracted DCOs providing dental services for Oregon Health Plan open card members. There are approximately 60,000 individuals serviced through this arrangement. While the coordinated care organizations (CCOs) operate on a five-year procurement cycle, the DCOs have not gone through such a procurement process since 2008. The DCO contract has gone through an annual restatement process incorporating legislative and rule changes. These changes, often developed for CCOs, have implications for DCOs as a result of this contractual relationship. With the implementation of CCO 2.0, significant changes were made resulting in new contractual requirements. The resulting administrative burden was overwhelming for DCOs, given their membership and budget is smaller than CCOs. Given this state, efforts were made to re-examine the current relationship between OHA and DCOs and find a solution that could best serve the needs of this population.
Through a collaborative effort between OHA and the DCOs, the decision was made to assign these members to CCOs through the activation of the CCO-F plan type. The CCO-F plan type is for the provision of dental services only. As a CCO member, these individuals will be able to access non-emergent medical transportation (NEMT) and utilize care coordination resources. This change will be effective January 1, 2023. Most DCOs have existing contractual relationships with most CCOs, which may facilitate less member disruption. Over the next year, OHA will work with DCOs and CCOs to ensure the smooth transition of DCO members.
Following the recent statement from the National Institutes of Health (NIH) COVID-19 Treatment Guidelines Panel regarding therapies for the COVID-19 Omicron variant, CMS created HCPCS code J0248 for remdesivir antiviral medication (VEKLURY™) when administered in an outpatient setting. This code is available for use by all payers and is effective for dates of service on or after December 23, 2021:
- Long descriptor: Injection, remdesivir, 1 mg
- Short descriptor: Inj, remdesivir, 1 mg
NIH currently recommends remdesivir as one of four treatment options for mild or moderate COVID-19 infection due to the Omicron variant. The other recommended therapies are oral Paxlovid™ (nirmatrelvir; ritonavir), intravenous sotrovimab, and oral molnupiravir. Paxlovid™, sotrovimab, and molnupiravir are currently available only through federal allocation, which is initially very limited, and Oregon’s allocation does not meet the current demand.
OHA recommends for use without prior authorization
Remdesivir is a commercially available product and treatment is time-sensitive. For this reason, Oregon Health Authority recommends that its use for treatment of patients with laboratory-confirmed COVID-19 at high risk of progression to severe illness should be allowed without prior authorization, until supply of other treatments are sufficient to meet demand. Read more here.
Assurance Wireless will no longer accept Lifeline applications for free cell phone and data service in Oregon.
Existing customers with Assurance Wireless will continue to receive free cell phone and data service through Thursday, March 31, 2022. After that date, they will need to switch to another phone carrier or a different program.
If members are interested in receiving free Lifeline wireless service from another provider, they can learn more and apply through the provider of their choice.
If members are enrolled in the Affordable Connectivity Program, formerly known as the Emergency Broadband Benefit program, through Assurance Wireless, they will continue to receive free unlimited voice, unlimited text, and unlimited data.
OHA has opened its first round of solicitations for the Clinical Supervision Program. This solicitation intends to provide financial awards to expand clinical supervision for behavioral health providers working toward licensure, particularly for Tribal members, members of Black communities, other communities of color and individuals who identify as LGBTQIA2S+.
HB 2949 provides $20 million for grants that support supervised clinical experience to associates or other individuals who have the necessary education but need supervised clinical experience to obtain a license to practice. This first round of funding will offer up to $3.5 million for community mental health programs and $3.5 million for private behavioral health providers.
The solicitation RFGP 5327 Behavioral Health Workforce Initiative Clinical Supervision Expansion (OregonBuys# S-44300-00001537) is posted on OregonBuys.
Please contact Nameun House for more information about this grant opportunity at Nameun.House@dhsoha.state.or.us or call: 503-373-7323.
Applications are due January 31, 2022 at 6:00 p.m.
All questions received through OregonBuys will be answered prior to the application deadline. For OregonBuys vendor registration and technical support, email support.oregonbuys@oregon.gov or call 1-855-800-5046.
The OHA health-related services (HRS) team has the following updated HRS guidance to share with CCOs:
- HRS and Health Information Technology (new): https://www.oregon.gov/oha/HPA/dsi-tc/Documents/Health-Related-Services-Guide-HIT.pdf
- Exhibit L Financial Reporting Template and HRS Expenditures (updated January 2022): https://www.oregon.gov/oha/HPA/dsi-tc/Documents/Health-Related-Services-Exhibit-L-Reporting-Guide.pdf
If you have questions, please reach out to health.relatedservices@dhsoha.state.or.us.
OHA is establishing an Oregon Resource Allocation Advisory Committee related to public health emergencies such as the COVID-19 pandemic. OHA is seeking applicants to participate on the committee which will begin convening this winter.
Scope
The role of the advisory committee will be to:
- Review and inform updates to OHA’s previously published Principles in Promoting Health Equity During Resource Constrained Events.
- Review and inform future amendments or changes to Oregon’s interim crisis care tool.
- Guide the development of any additional necessary resources (e.g., toolkit, guidance, best practices) to ensure OHA’s principles in health equity can be readily applied in Oregon during a resource constrained event.
- Inform norms and expectations regarding communication and transparency when health system allocation decisions are necessary due to resources constraints.
Membership
The Oregon Resource Allocation Advisory Committee will be assembled to ensure representation from the health care delivery system as well as broad community representation. OHA is seeking members for this advisory committee including:
- Organizations and community members who can speak to community needs, especially communities of color, Tribal communities and people with disabilities, including people with intellectual and developmental disabilities.
- Partners engaged in Oregon’s health care delivery system, such as hospitals, healthcare providers, ethicists and local public health. Healthcare representatives may include those with expertise in critical care, trauma, emergency medical services, pediatrics, ethics,equity and other subspecialty care.
Applications are due Friday, January 28, 2022.
For more background related to this committee, including adopted documents and stipend information as well as other details, please review the Call for applications announcement. To apply, please see the committee application.
At the 12/14 OHA Medicaid Advisory Committee meeting, Lavinia Goto and Jackie Wetzel shared recommendations from the Advancing Consumer Experiences Subcommittee. The consumer subcommittee was formed in 2020 to better understand consumer challenges and identify opportunities to improve the consumer experience. Please see below for follow-up resources from this presentation:
If you have any questions, please reach out to MAC.Info@dhsoha.state.or.us.
Providers should attempt to always have at least a 30-day supply of PPE. Use the Residential Facility Personal Protective Equipment PPE Checklist to assess your stock of PPE at regular intervals that allow for timely restocking even before there is a case of COVID-19.
If you have any questions, Contact the Coronavirus Response and Recovery Unit (CRRU) at 503-979-3377 or email CRRU@dhsoha.state.or.us.
Rates as of 01/12/2022
      
January 18, 2022
January 19, 2022
Please visit the committee and workgroup links below for more information about meetings. You can also view the OHA Public Meeting calendar.
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