The Oregon Health Authority (OHA) has contracted with HSAG to conduct a review of Coordinated Care Organizations' (CCOs') compliance with federal (42 CFR 438) and state regulations that address standards related to access, structure and operations, and quality measurement and improvement. Within each three-year compliance cycle, the EQRO will review a full set of standards, with follow-up being conducted during subsequent years to assess corrective actions taken to address deficiencies.
The following figure highlights the three-year compliance cycle and when individual standards will be reviewed:
HSAG uses information and data derived from compliance reviews to reach conclusions and make recommendations about the quality, timeliness, and access of care of Medicaid services provided to Medicaid enrollees.
For questions related to the compliance monitoring review activity, please contact:
Brittony Stewart, MS
Project Manager II, State & Corporate Services
Telephone: 602.732.9308
Email: BStewart@hsag.com
Oregon Medicaid EQRO
- Compliance Monitoring Reviews
- Fraud, Waste, and Abuse Reviews
- Performance Improvement Projects
- Network Access Evaluations
- Performance Measure Validation
- Information Systems Capability Assessments
- Annual Technical Report
- Encounter Data Validation
- Mental Health Parity
- Contact Us
- Abbreviations and References
