MedicaidAdministrativeMedium impact
Document submission for 2022 Compliance Monitoring Review – ORS 414.595
Oregon Health Plan·OR·Plan
Effective date
Mar 1, 2022
We identified it
Aug 19, 2026
Summary
Oregon Health Authority is establishing compliance monitoring review (CMR) document submission requirements for Coordinated Care Organizations (CCOs) and Dental Care Organizations (DCOs) under ORS 414.595. Managed care entities must identify required documentation from provided deliverable lists, submit documentation requests to OHA by March 7, 2022, and ensure all necessary documentation reaches the external quality review organization (HSAG) by the CMR deadline. This is an administrative/compliance requirement affecting Oregon Medicaid managed care plans.
Action Required
By March 7, 2022: Billing and compliance teams must (1) Review the 2022 CCO or DCO Deliverables lists (Exhibit D) applicable to your organization; (2) Identify which contract deliverable documents your practice has and should submit for the 2022 CMR; (3) Submit a list of requested documentation via email to HSD.QualityAssurance@dhsoha.state.or.us. Beginning March 2022: Ensure all identified documentation is compiled and submitted to HSAG. Billing/compliance teams are responsible for verifying HSAG receives all necessary documentation, regardless of whether OHA or your organization submits it. Consider submitting duplicate copies of documentation OHA provides. Complete the HSAG CMR tool with accurate detail showing where in documentation submissions the required information can be found. Failure to submit required documentation or incomplete CMR tools may result in compliance violations or audit findings.