Or. Admin. Code § 410-149-0130

Current through Register Vol. 63, No. 11, November 1, 2024

Section 410-149-0130 - Care Management Fees

(1) The Authority shall provide care management fees as a PMPM payment to practice sites for FFS OHP attributed members. These payments shall be used to:

(a) Provide up-front investment in participating practices; and

(b) Assist practices to continue practice transformation efforts and offer comprehensive integrated services for patients.

(2) Care management fees vary by practice track and PCPCH tier and are issued in the following amounts:

(a) Track 1:

(A) Tier 1 PCPCH qualifies for $2 PMPM;

(B) Tier 2 PCPCH qualifies for $4 PMPM;

(C) Tier 3 PCPCH qualifies for $6 PMPM;

(D) Tier 4 PCPCH qualifies for $8 PMPM;

(E) Tier 5-STAR PCPCH qualifies for $10 PMPM.

(b) Track 2:

(A) Tier 3 PCPCH qualifies for $9 PMPM;

(B) Tier 4 PCPCH qualifies for $12 PMPM;

(C) Tier 5-STAR PCPCH qualifies for $18 PMPM.

Or. Admin. Code § 410-149-0130

DMAP 31-2017(Temp), f. 7-28-17, cert. ef. 8-1-17 thru 1-27-18; DMAP 5-2018, adopt filed 01/24/2018, effective 1/24/2018

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 413.042, 413.259 & 414.065