Our notes from the Q & A Session with the OHA:
A list of questions and Answers:-Will there be a template posted for letters of support and are there minimum requirements for these letters:
A. There are no minimum requirements or template, OHA is asking for community support.
- There was a question regarding a specific section around anti-trust, and OHA will be writing a response and posting it.
- Can or should an applicant add details to letters?
A. Any information you can add will be welcome
- What are the minimum requirements to become a CCO?
A. Refer to the RFA itself that is posted on the website.
- Will forming a CCO take place of current IPA's in this area?
A. CCOs will not replace IPAs, the expectation is that IPAs most likely will be part of the organizations that come together to form CCOs but each region is going to be different.
- CCOs will result in fewer third party payors, how are you addressing this and have you given thought on giving organizations thoughts on how to consolidate?
A. Interesting question that will take thought and be different in each area. OHA will respond to this in writing, but recommends referring to the RFA.
- Do you consider letters of intent the same as memorandums of understanding?
A. They were unclear of the legal meaning on memorandums of understanding.
- Can you speak to requested waivers for Indian Health Organizations?
A. There are a lot of considerations for tribes in federal and state law as well as the bills that went through the legislature. Those are built into the RFA, and OHA suggests reading of the RFA for further understanding, and will address more in a written response.
- Is there a prescribed amount of process transparency required on behalf of applicants?
A. OHA is not completely clear on the question and would ask for a clarifying question. There is not currently a prescribed level of transparency. The applications will be part of the Oregon Public Records law which allows some proprietary information to be protected. OHA will make everything public that they possibly can. Where OHA leaves off and CCOs begin, there may be some differences in what they are able to make transparent.
- Where and when will letters of intent be posted?
A. Letters of Intent will be posted April 2nd or 3rd on the health.oregon.gov website.
- If administrative functions are handled outside of an organization will you accept a tmtm budget, or will you require a line by line budgetA. No one from actuarial services is in the room, so they will respond in writing.
- Will comments on the core contract be considered?
A.Comments will be considered. It is very close to the final document but can be changed, and likely will be as the rules are developed.
- Will more than one CCO be accepted per area?
A. Yes, there is not intent to limit the number of CCOs
- Does the change with respect to medicare alignment mean that a CCO does not have to file a letter of intent to participate with CMS?
A. OHA is encouraging all CCOs to submit a letter of intent as those are non-binding, but it is not required.
- Will there be any opportunity to better understand services such as non-emergent transportation?
A. That will be responded to in writing, and is part of global buget work that is on going.
- Are you seeking innovations in care and where are these considered if so?
A. Go to the website, there is an entire section that outlines innovations in care and asks applicants to put forward innovations as part of the process.
- When will written responses to questions be posted?
A. Time permitting, some will be posted Monday. As many as possible will be posted today.
- There is not a table defining all medicaid funded programs, where can this be found.
A. This will be responded to in writing as well.
- Do CCOs have to identify names of board members or just areas they represent?
A. They have to be named
- How will patients be assigned to CCOs in the event there are multiple CCOs.
A. In general, there is hope that people will choose their CCO.
- Will there need to be a minimum number of people served?
A. There needs to be a minimum number, although it won't be prescribed. It will be part of the review process to evaluate the capability of the CCO to manage the risk. There will be a number of factors.
- Any reccomendations for gaining support in connecting with local governments?
A. The Governor's office has some support systems, they will respond further in writing.
- Since many CCOs have no experience in managing mental health services, who will CCOs approach for managing and funding of these services?
A. A piece of this will come with connectivity with local county government as well as community organizations.
- Do you expect CCO applicants to have executed provider contracts by April 30th?
A. OHA expect provider contracts be executed by the start date in August, understanding that part of the application process is an adequate provider network.
- What are the expectations as part of the initial RFA submission?
A. Complete response to all of the questions within the RFA within the page limits.
- Will there be financial incentives for applicants in the first wave compared to later applicants?
A. At this time there are no plans for this.
- Many CCOs will probably contract with affiliates for other administrative services and other things, are there any services a CCO cannot contract for?
A. There are none that they can think of, they will give a more detailed written response.
- Are you expecting one letter of intent per CCO contract?
A. Yes.
- Does the letter of the intent need to be in the exact format of that in the RFA?
A. Yes, we want to get the information in that format consistently from all the CCOs.
- A. The existing MCO can continue in Business through the end of June 2014. If necessary, OHA can review and renew contracts through 2017. It would be up to the governance of an MCO to determine if they want to continue. If so they would have to meet all the requirements of being a CCO and they would be allowed to continue.
- What is the status of the state's waiver request to not have to use actuarial soundness around payments to CCOs.
A. That is not actually a waiver that was requested. The flexibility OHA asked for was for Actuarial sound rates with fixed budgets.
- We have been getting mixed messaged about MCO contracts. We have been hearing MCOs will be required to meet CCOs requirements even if not ready to become CCOs.
A. There are some requirements in HB3650 in order to advance transformation. OHA is currently working on how to implement these requirements realistically.
