Or. Admin. R. 410-141-5255 - CCO ACQUISITIONS AND MERGERS: Purpose; Definitions
Current through Register Vol. 60, No. 12, December 1, 2021
(1) The purpose of
OAR 410-141-5255 to OAR 410-141-5285 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
414.620.
(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
410-141-5285:
(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 will
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, 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, 414.615, 414.625, 414.635 & 414.651
Statutes/Other Implemented: ORS 414.610 - 414.685
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