Or. Admin. Code § 410-141-5255 - CCO ACQUISITIONS AND MERGERS: Purpose; Definitions
(1) The purpose of
OAR 410-141-5255 to OAR
410-141-5280 is that of
regulating the control or ownership of a CCO or of a CCO holding company
system, in order to promote the public interest including the interests of CCO
Members and stakeholders and to advance the goals and mission of the Authority
and the Oregon Integrated and Coordinated Care Delivery System described in ORS
414.018 and ORS
414.570.
(2) The Authority shall adhere to the
following guiding principles when reviewing proposed acquisitions:
(a) The health of Oregon Health Plan members
and all Oregonians are at the center when analyzing potential impacts of
proposed acquisitions;
(b) Health
equity, access to care, health care quality, and costs are
fundamental;
(c) The process shall
be transparent, robust and informed by the public and stakeholders through
meaningful engagement; and
(d) The
Authority shall use resources wisely and collaborate with DCBS when
applicable.
(3) Unless
the context otherwise requires, as used in OAR
410-141-5255 to OAR
410-141-5280:
(a) "Acquiring party" means a person that
acquires or attempts to acquire control of a CCO, that enters into an agreement
to merge with or otherwise acquire control of a CCO as described in OAR
410-141-5260 or that engages in
an activity described in OAR
410-141-5260, or an intermediary
or subsidiary corporation that holds, directly or indirectly, the assets or
voting securities or assumes the liabilities of a CCO or other
entity;
(b) "Acquisition" means an
agreement, arrangement or activity that results in a person acquiring control
of another person, directly or indirectly, including but not limited to an
acquisition of voting securities, a merger, an acquisition of assets or bulk
reinsurance;
(c) "Coordinated Care
Organization (CCO)" means a CCO or a person that controls a CCO;
(d) "Health Equity" definition: Oregon shall
have established a health system that creates health equity when all people can
reach their full health potential and well-being and are not disadvantaged by
their race, ethnicity, language, disability, age, gender, gender identity,
sexual orientation, social class, intersections among these communities or
identities, or other socially determined circumstances. Achieving health equity
requires the ongoing collaboration of all regions and sectors of the state,
including tribal governments to address:
(A)
The equitable distribution or redistributing of resources and power;
and
(B) Recognizing, reconciling
and rectifying historical and contemporary injustices.
(e) "Significant portion" means, when
acquired in one transaction or in a related or integrated series of
transactions within any consecutive twelve-month period, ten percent or more
of:
(A) The assets of the CCO; or
(B) The CCO's in-force benefit
contracts.
Notes
Statutory/Other Authority: ORS 413.042, 414.572, 414.591 & 414.605
Statutes/Other Implemented: ORS 414.570-414.686 & 415.001-415.430
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.
No prior version found.