ORS 414.609: Network adequacy; member transfers.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) A coordinated care organization that contracts with the Oregon Health Authority must maintain a network of providers, including but not limited to addiction treatment providers, sufficient in numbers and areas of practice and geographically distributed in a manner to ensure that the health services provided under the contract are reasonably accessible to members. (2) A member may transfer from one organization to another organization no more than once during each enrollment period. [Formerly 414.645; 2024 c.70 §10]
Administrative rules citing this section
- OAR 410-141-3505: Use of Subcontractors — implements
- OAR 410-141-3515: Network Adequacy — implements
- OAR 410-141-3525: Outcome and Quality Measures — implements
- OAR 410-141-3570: Managed Care Entity Encounter Claims Data Reporting — implements
- OAR 410-141-3575: MCE Member Relations: Marketing — implements
- OAR 410-141-3700: CCO Application and Contracting Procedures — implements
- OAR 410-141-3730: Community Health Assessment and Community Health Improvement Plans — implements
- OAR 410-141-3735: Social Determinants of Health and Equity; Health Equity — implements
- OAR 410-141-3855: Temporary rule language in effect until 10/27/2026. Pharmaceutical Services — implements
- OAR 410-141-3870: Care Coordination: Service Coordination — implements
- OAR 410-141-3900: Grievances & Appeals: Contested Case Hearings — implements
- OAR 410-141-5000: FINANCIAL SOLVENCY REGULATION: Definitions — implements
- OAR 410-141-5005: FINANCIAL SOLVENCY REGULATION: CCO Financial Solvency Requirements — implements
- OAR 410-141-5010: FINANCIAL SOLVENCY REGULATION: Procedure for General Financial Reporting and for Determining Financial Solvency Matters — implements
- OAR 410-141-5015: FINANCIAL SOLVENCY REGULATION: Financial Statement Reporting — implements
- OAR 410-141-5020: FINANCIAL SOLVENCY REGULATION: Annual Audited Financial Statements and Auditor’s Report — implements
- OAR 410-141-5025: FINANCIAL SOLVENCY REGULATION: Qualifications of Independent Certified Public Accountant — implements
- OAR 410-141-5030: FINANCIAL SOLVENCY REGULATION: Notification of Adverse Financial Condition — implements
- OAR 410-141-5035: FINANCIAL SOLVENCY REGULATION: Accountant's Letter of Qualifications — implements
- OAR 410-141-5040: FINANCIAL SOLVENCY REGULATION: Independent Certified Public Accountants Workpapers — implements
- OAR 410-141-5045: FINANCIAL SOLVENCY REGULATION: Corporate Governance Annual Disclosure Filing — implements
- OAR 410-141-5050: FINANCIAL SOLVENCY REGULATION: Requirements for Reinsurance — implements
- OAR 410-141-5055: FINANCIAL SOLVENCY REGULATION: Requirements for Obtaining Credit for Reinsurance — implements
- OAR 410-141-5060: FINANCIAL SOLVENCY REGULATION: Qualified Trust Agreements — implements
- OAR 410-141-5065: FINANCIAL SOLVENCY REGULATION: Letters of Credit; Other Security — implements
- OAR 410-141-5070: FINANCIAL SOLVENCY REGULATION: Assets, Liabilities, Reserves — implements
- OAR 410-141-5075: FINANCIAL SOLVENCY REGULATION: Disallowance of Certain Reinsurance Transactions — implements
- OAR 410-141-5080: FINANCIAL SOLVENCY REGULATION: Transparency — implements
- OAR 410-141-5085: ASSET VALUATION AND PERMITTED INVESTMENTS: Definitions — implements
- OAR 410-141-5090: ASSET VALUATION AND PERMITTED INVESTMENTS: Calculation of Value; Books and Records — implements
- OAR 410-141-5095: ASSET VALUATION AND PERMITTED INVESTMENTS: Assets Other Than Securities; Bonds; Real Property; Mortgages; Compensating Balances — implements
- OAR 410-141-5100: ASSET VALUATION AND PERMITTED INVESTMENTS: Investments Used to Provide Compensating Balances — implements
- OAR 410-141-5105: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Required Capitalization — implements
- OAR 410-141-5110: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Mortgage Loans — implements
- OAR 410-141-5115: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Real Property — implements
- OAR 410-141-5120: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Corporate Stocks — implements
- OAR 410-141-5125: ASSET VALUATION AND PERMITTED INVESTMENTS: Loans; Security; Limitations — implements
- OAR 410-141-5130: ASSET VALUATION AND PERMITTED INVESTMENTS: Investments; Certain Obligations, Property, Loans and Other Specified Items — implements
- OAR 410-141-5135: ASSET VALUATION AND PERMITTED INVESTMENTS: Personal Property; Protection of Investment Property; Custom — implements
- OAR 410-141-5140: ASSET VALUATION AND PERMITTED INVESTMENTS: “Prudent Investor” Standard — implements
- OAR 410-141-5145: ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Conduct by Directors, Trustees, Officers, Agents or Employees — implements
- OAR 410-141-5150: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Funds in Obligations That Are Not Investment Quality; Percentage of Assets — implements
- OAR 410-141-5155: ASSET VALUATION AND PERMITTED INVESTMENTS: Approval by Board — implements
- OAR 410-141-5160: ASSET VALUATION AND PERMITTED INVESTMENTS: Record of Investments — implements
- OAR 410-141-5165: ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Investments — implements
- OAR 410-141-5170: CAPITALIZATION: Capital and Surplus — implements
- OAR 410-141-5175: CAPITALIZATION: Impaired Capital and Surplus — implements
- OAR 410-141-5180: CAPITALIZATION: Dividend and Distribution Restrictions — implements
- OAR 410-141-5185: CAPITALIZATION: Restricted Reserve Account — implements
- OAR 410-141-5186: CAPITALIZATION: Restricted Reserve Account—Permitted Investments in Obligations with Political Subdivisions; Public Supported Housing — implements
- OAR 410-141-5190: CAPITALIZATION: Surplus Notes — implements
- OAR 410-141-5195: CAPITALIZATION: Risk-based Capital (RBC) Definitions — implements
- OAR 410-141-5200: CAPITALIZATION: RBC Reports — implements
- OAR 410-141-5205: CAPITALIZATION: Company Action Level Event — implements
- OAR 410-141-5210: CAPITALIZATION: Regulatory Action Level Event — implements
- OAR 410-141-5215: CAPITALIZATION: Authorized Control Level Event — implements
- OAR 410-141-5220: CAPITALIZATION: Mandatory Control Level Event — implements
- OAR 410-141-5225: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Extraordinary Dividends and Other Distributions — implements
- OAR 410-141-5230: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Reports of Material Acquisitions And Dispositions Of Assets, and Changes to Ceded Reinsurance Agreements; Assumption Reinsurance — implements
- OAR 410-141-5235: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Reports of Material Materiality and Reporting Standards for Asset Acquisitions and Dispositions — implements
- OAR 410-141-5240: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Materiality and Reporting Standards for Changes in Ceded Reinsurance Agreements — implements
- OAR 410-141-5245: EXAMINATIONS: CCO Production of Books and Records — implements
- OAR 410-141-5250: EXAMINATIONS: Authority Examinations of CCOs — implements
- OAR 410-141-5255: CCO ACQUISITIONS AND MERGERS: Purpose; Definitions — implements
- OAR 410-141-5260: CCO ACQUISITIONS AND MERGERS: Activities Prohibited Unless Certain Provisions Satisfied — implements
- OAR 410-141-5265: CCO ACQUISITIONS AND MERGERS: Procedure For Acquiring Controlling Interest — implements
- OAR 410-141-5270: CCO ACQUISITIONS AND MERGERS: Information to Be Included in Form A — implements
- OAR 410-141-5275: CCO ACQUISITIONS AND MERGERS: Hearing, Request, Notice — implements
- OAR 410-141-5278: CCO ACQUISITIONS AND MERGERS: Confidentiality — implements
- OAR 410-141-5280: CCO ACQUISITIONS AND MERGERS: Determination Concerning Proposed Activity, Time For Decision, Grounds For Refusal — implements
- OAR 410-141-5283: CCO ACQUISITIONS AND MERGERS: Compliance with Conditions — implements
- OAR 410-141-5285: CCO HOLDING COMPANY REGULATION: Definitions — implements
- OAR 410-141-5290: CCO HOLDING COMPANY REGULATION: Members of Holding Company Systems; Registration Requirements — implements
- OAR 410-141-5295: CCO HOLDING COMPANY REGULATION: Form and Contents of Registration Statement — implements
- OAR 410-141-5300: CCO HOLDING COMPANY REGULATION: Registration Statement Filing — implements
- OAR 410-141-5305: CCO HOLDING COMPANY REGULATION: Information Required to Be Disclosed — implements
- OAR 410-141-5310: CCO HOLDING COMPANY REGULATION: Presumption of Control; Rebuttal — implements
- OAR 410-141-5315: CCO HOLDING COMPANY REGULATION: Disclaimer of Affiliation — implements
- OAR 410-141-5318: CCO Holding Company Regulation: Group Capital Calculation — implements
- OAR 410-141-5320: CCO HOLDING COMPANY REGULATION: Transactions Within Holding Company — implements
- OAR 410-141-5323: CCO HOLDING COMPANY REGULATION: Transaction Types Within Holding Company for Disclosure — implements
- OAR 410-141-5325: CCO HOLDING COMPANY REGULATION: Director and Officer Liability; Effect of Control of CCO Subject to Registration; Board of Directors — implements
- OAR 410-141-5330: CCO HOLDING COMPANY REGULATION: Annual Enterprise Risk Report — implements
- OAR 410-141-5335: CCO HOLDING COMPANY REGULATION: Disclaimers and Termination of Registration — implements
- OAR 410-141-5340: CCO HOLDING COMPANY REGULATION: Forms; General Requirements — implements
- OAR 410-141-5345: CCO HOLDING COMPANY REGULATION: Forms; Incorporation by Reference, Summaries, And Omissions — implements
- OAR 410-141-5350: CCO HOLDING COMPANY REGULATION: Forms; Information Unknown or Unavailable and Extension of Time to Furnish — implements
- OAR 410-141-5355: CCO HOLDING COMPANY REGULATION: Forms; Additional Information; Amendments — implements
- OAR 410-141-5360: CCO INSOLVENCY AND DISSOLUTION: Access to Funds and Transition of Members and Records — implements
- OAR 410-141-5365: CCO INSOLVENCY AND DISSOLUTION: Hazardous Operations — implements
- OAR 410-141-5370: CCO INSOLVENCY AND DISSOLUTION: Recovery From Parent Corporation Or Holding Company In The Event Of Liquidation Or Rehabilitation — implements
- OAR 410-141-5375: CCO INSOLVENCY AND DISSOLUTION: Voluntary Dissolution; Approval of Plan — implements
- OAR 410-141-5380: CIVIL PENALTIES — implements
This rule cites
No citations extracted.
Cited by
- ORS 413.181: Disclosure of insurer information by Department of Consumer and Business Services for purpose of administering Oregon Integrated and Coordinated Care Delivery System.
- ORS 414.611: Transfer of 500 or more members of coordinated care organization.
- ORS 414.769: Payment for gender-affirming treatment; rules.
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors414.html