Bill > HB2238

This bill modifies Oregon's Coordinated Care Organization (CCO) model by extending contract terms from five to ten years, with a provision for reevaluation after the initial five years. The bill introduces new restrictions on contract amendments, requiring more transparency and notice periods. It establishes a process for CCOs to enter new service areas, which involves a comprehensive assessment considering factors like existing service quality and network adequacy. The Oregon Health Authority is directed to study barriers to operating within global budgets and to establish a minimum medical loss ratio for CCOs, which measures the percentage of revenues spent on medical costs. The bill also expands health outcome and quality measures to include fee-for-service medical assistance providers, ensuring they are held to similar performance standards as CCOs. Additionally, the bill requires the authority to collect input from various stakeholders when developing these measures and mandates reporting on health outcomes. The legislation declares an emergency, meaning it will take effect immediately upon passage, with most provisions becoming operative on December 1, 2025. The goal is to improve healthcare delivery, increase accountability, and ensure more consistent and high-quality medical services across Oregon's healthcare system.

Health and Social Services

https://olis.oregonlegislature.gov/liz/2025R1/Measures/Overview/HB2238