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83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
House Bill 2207
Introduced and printed pursuant to House Rule 12.00. Presession filed (at the request of House Interim Committee
on Behavioral Health and Health Care for Representative Rob Nosse)
SUMMARY
The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject
to consideration by the Legislative Assembly. It is an editor’s brief statement of the essential features of the
measure as introduced.The statement includes a measure digest written in compliance with applicable readability
standards.
Digest: The Act tells OHA to adopt standards for certain reviews of CCOs. (Flesch Readability
Score: 74.8).
Directs the Oregon Health Authority to adopt standards for external quality reviews of coordi-
nated care organizations that are aligned with standards published by the National Committee for
Quality Assurance.
Takes effect on the 91st day following adjournment sine die.
A BILL FOR AN ACT
Relating to external quality reviews of coordinated care organizations; creating new provisions;
amending ORS 414.595; and prescribing an effective date.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 414.595 is amended to read:
414.595. (1) As used in this section:
(a) “Coordinated care organization” has the meaning given that term in ORS 414.025.
(b) “Subcontractor” means an entity that contracts with a coordinated care organization to
provide health care, dental care, behavioral health care or other services to medical assistance re-
cipients enrolled in the coordinated care organization.
(2)(a) The Oregon Health Authority shall conduct one external quality review of each coordi-
nated care organization annually. The authority may contract with an external quality review or-
ganization to conduct the review.
(b) The authority shall adopt standards for evaluating a coordinated care organization
during an external quality review. The standards must be aligned with the health plan ac-
creditation standards published by the National Committee for Quality Assurance.
(c) If a coordinated care organization has received accreditation from the National
Committee for Quality Assurance for a standard adopted under this section, the authority
shall accept proof of the accreditation as evidence that the coordinated care organization has
complied with the standard.
(3) The authority shall compile a standard list of documents that the authority or contracted
review organization collects from coordinated care organizations and subcontractors. When re-
questing information from a coordinated care organization about its subcontractors, the authority
or contracted review organization shall inform the coordinated care organization of the documents
on the standard list that have been collected from the coordinated care organization’s subcontrac-
tors in the preceding 12-month period.
(4) The authority or a contracted review organization may not request information from a co-
ordinated care organization that is duplicative of or redundant with information previously provided
NOTE:Matter in boldfaced type in an amended section is new; matter [italic and bracketed] is existing law to be omitted.
New sections are in boldfaced type.
LC 2429 HB2207
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by the coordinated care organization or a subcontractor if the information was provided within the
preceding 12-month period and the relevant content of the information has not changed.
(5) The authority shall provide a contracted review organization with all information about a
coordinated care organization in the authority’s possession as necessary for the contracted review
organization to conduct the external quality review. A contracted review organization may not seek
information from a coordinated care organization before first requesting the information from the
authority.
(6) This section does not apply to documents requested, submitted or collected in connection
with an audit for or an investigation of fraud, waste or abuse and does not:
(a) Prohibit a coordinated care organization from requesting from a subcontractor information
required by law or contract;
(b) Require the authority or a contracted review organization to disclose to a coordinated care
organization any information described in this section collected from a coordinated care organiza-
tion or a subcontractor; or
(c) Permit the authority or a contracted review organization to disclose to a coordinated care
organization confidential or proprietary information reported to the authority or contracted review
organization by another coordinated care organization or a subcontractor.
SECTION 2. The amendments to ORS 414.595 by section 1 of this 2025 Act apply to ex-
ternal quality reviews conducted on or after the operative date specified in section 3 of this
2025 Act.
SECTION 3. (1) The amendments to ORS 414.595 by section 1 of this 2025 Act become
operative on January 1, 2026.
(2) The Oregon Health Authority may take any action before the operative date specified
in subsection (1) of this section that is necessary to enable the authority to exercise, on and
after the operative date specified in subsection (1) of this section, all of the duties, functions
and powers conferred on the authority by the amendments to ORS 414.595 by section 1 of this
2025Act.
SECTION 4.This 2025 Act takes effect on the 91st day after the date on which the 2025
regular session of the Eighty-third Legislative Assembly adjourns sine die.
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