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Oregon Medicaid EQRO

Diverse Business Group Business Audience

Oregon Medicaid External Quality Review Organization

  • As required by 42 CFR §438.358, a state Medicaid agency, an EQRO, or the state’s agent that is not a Medicaid MCO, PAHP, or PIHP may perform the mandatory and optional EQR-related activities to obtain data to support production of the annual EQR as described in 42 CFR §438.350.
  • HSAG has been contracted by OHA as the EQRO for Oregon beginning July 2018 and is currently the largest EQRO in the nation, with EQRO contracts in 19 states.

For more information about the Oregon EQRO contract, contact:

       Thomas "Tom" Miller, MA
       Executive Director, State & Corporate Services
       Telephone: 602.341.4992

EQRO and EQR-Related Activities

HSAG performs the following EQR-related activities for Oregon’s Medicaid managed care program:

  • Compliance Monitoring Reviews
  • Fraud, Waste, and Abuse Reviews
  • Validation of Performance Improvement Projects
  • Network Access Evaluations
  • Validation of Performance Measures
  • Information Systems Capabilities Assessments
  • Annual Technical Report
  • Encounter Data Validation
  • Mental Health Parity Assessment

EQRO Webinars and Technical Assistance