Or. Admin. R. 410-115-0050

Current through Register Vol. 63, No. 9, September 1, 2024

Section 410-115-0050 - OHP Bridge - BHP Trust Fund

The Authority shall maintain an OHP Bridge - BHP Trust Fund for the receipt of the federal funds and other non-federal funds the Authority is required to use to pay for the Basic Health Program. Pursuant to 42 CFR 600.705, the Authority does not have the right to use the funds maintained in the BHP Trust for any purpose other than the following:

(1) Paying contracted rates to the CCOs for providing OHP Bridge - Basic Health Program covered services to OHP Bridge - Basic Health Program members (including ancillary payments related to CCO or provider (or both) performance incentives, risk management, and similar purposes as set forth in the OHP Bridge - Basic Health Program CCO Contract);

(2) Paying the CCOs to provide additional covered services or benefits to OHP Bridge - Basic Health Program members, which may be delivered through a network managed by the Authority or its administrator;

(3) Paying health care providers directly for covered services that are not included in the OHP Bridge - Basic Health Program CCO contract(s), but are included in the BRG Benefit Package defined in OAR 410-115-0030; and,

(4) Paying health care providers directly to augment amounts paid by CCOs for services delivered to OHP Bridge - Basic Health Program members.

Or. Admin. R. 410-115-0050

DMAP 94-2024, adopt filed 05/29/2024, effective 6/1/2024

Statutory/Other Authority: ORS 413.042, 414.241, 414.245, 42 CFR 600, 600.700, 600.705, 600.710 & 600.715

Statutes/Other Implemented: ORS 413.042, 414.241, 414.245 & ORS 414.065