Or. Admin. R. 410-149-0130 - Care Management Fees

(1) The Authority shall provide care management fees as a PMPM payment to practice sites for FFS OHP attributed members. These payments shall be used to:
(a) Provide up-front investment in participating practices; and
(b) Assist practices to continue practice transformation efforts and offer comprehensive integrated services for patients.
(2) Care management fees vary by practice track and PCPCH tier and are issued in the following amounts:
(a) Track 1:
(A) Tier 1 PCPCH qualifies for $2 PMPM;
(B) Tier 2 PCPCH qualifies for $4 PMPM;
(C) Tier 3 PCPCH qualifies for $6 PMPM;
(D) Tier 4 PCPCH qualifies for $8 PMPM;
(E) Tier 5-STAR PCPCH qualifies for $10 PMPM.
(b) Track 2:
(A) Tier 3 PCPCH qualifies for $9 PMPM;
(B) Tier 4 PCPCH qualifies for $12 PMPM;
(C) Tier 5-STAR PCPCH qualifies for $18 PMPM.

Notes

Or. Admin. R. 410-149-0130
DMAP 31-2017(Temp), f. 7-28-17, cert. ef. 8-1-17 thru 1-27-18; DMAP 5-2018, adopt filed 01/24/2018, effective 1/24/2018

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 413.042, 413.259 & 414.065

State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.