MedicaidAdministrativeMedium impact
Contract and rule errors relating to encounter data
Oregon Health Plan·OR·Plan contract
We identified it
Jun 20, 2026
Summary
This policy communication alerts Coordinated Care Organizations (CCOs) in Oregon to two technical errors in CCO 2.0 contracts and state regulations regarding encounter data submission timelines. The contract language regarding the 63-day resubmission deadline for corrected encounter data was incomplete, and an Oregon Administrative Rule contained an incorrect cross-reference. These errors will be corrected in future contract and rule updates, but practices should be aware of the current ambiguity when submitting encounter data corrections to OHA.
Action Required
Immediately: Billing and encounter data teams should be aware that the current CCO 2.0 contract (effective October 1, 2019) and OAR 410-141-3570 contain technical errors that may create confusion when OHA requests encounter data corrections. When OHA sends notice of Encounter Data Requiring Correction, billing teams must strictly adhere to the 63-day resubmission deadline (or shorter period if specified in OHA's notice) as described in Exhibit B, Part 8, Section 11.c of the contract. Contact your OHA encounter data liaison immediately if you receive encounter data correction notices and need clarification on submission requirements or timeframes. Do not rely on the current incomplete contract language—wait for official guidance from OHA. Flag any communications from OHA regarding encounter data corrections for supervisory review given the known contract ambiguities.