MedicaidAdministrativeLow impact
Change in reporting of member enrollment in Patient Centered Primary Care Homes 02242020
Oregon Health Plan·OR·Plan contract
Effective date
Oct 1, 2019
We identified it
Aug 19, 2026
Summary
Oregon Health Authority (OHA) has changed the Patient Centered Primary Care Homes (PCPCH) enrollment reporting requirement from quarterly to annual submission for Coordinated Care Organizations (CCOs) under CCO 2.0 contracts. Reports are now due annually within 30 days following the end of each contract year, with the first annual report due by January 30, 2021. Facility-level data submission via online survey portal continues, though OHA reserves the right to request member-level data.
Action Required
By January 30, 2021: Billing and administrative staff at CCO-contracted practices must prepare and submit the first annual PCPCH enrollment report (previously submitted quarterly). Coordinate with your Coordinated Care Organization to ensure member enrollment data by PCPCH tier levels (1-5) is compiled and submitted via the OHA online survey portal. Going forward, this report is due annually by the 30th day following the end of each contract year instead of quarterly. Failure to submit may impact CCO performance monitoring and OHA's reporting obligations to CMS, though this is not a direct billing compliance issue for individual providers.