(1) If the Department of Human Services has not been able to contract with the fully capitated health plan or plans in a designated area, the department may contract with a physician care organization in the designated area.
(2) The Office for Oregon Health Policy and Research shall develop criteria that the department shall consider when determining the circumstances under which the department may contract with a physician care organization. The criteria developed by the office shall include but not be limited to the following:
(a) The physician care organization must be able to assign an enrollee to a person or entity that is primarily responsible for coordinating the physical health services provided to the enrollee;
(b) The contract with a physician care organization does not threaten the financial viability of other fully capitated health plans in the designated area; and
(c) The contract with a physician care organization must be consistent with the legislative intent of using prepaid managed care health services organizations to provide services under ORS 414.705 to 414.750. [2003 c.810 §5]
Note: See note under 414.736.Section: Previous 414.725 414.727 414.728 414.730 414.735 414.736 414.737 414.738 414.739 414.740 414.741 414.742 414.743 414.744 414.745 Next
Last modified: August 7, 2008