EOCCO Clinics & Staff,
Welcome to the December 2024 issue of the EOCCO monthly newsletter. Below is a preview of the articles you will find in this month's email:
News From EOCCO:
- Reminder: Timely Access to Care survey
- Health-related social needs (HRSN): Nutrition benefit
- New program launching Jan.1, 2025: Young Adults with Special Health Care Needs (YSHCN)
- Linguava interpreter services contract ending Dec. 31, 2024
- EOCCO seclusion and restraint policy
- IET measure learning collaborative: Thursday, Jan. 23, 2025
- 2025 calendar year timeline
From our partners:
- Rural Health Care Telecommunications (Telecom) Program
- Family Connects Oregon in Malheur County
- New OHA certified/qualified health care interpreter registry file
Plese let us know if you have any questions, concerns or recommendations. We would love to hear from you!
Please contact: EOCCO Provider Inquiry
Thank you,
Your EOCCO Team
Reminder: Timely Access to Care survey
An email was sent out on Dec. 11 for primary care, specialist and urgent care clinics to complete our Timely Access to Care survey. As a reminder, this survey is sent out twice a year.
EOCCO is required to follow Oregon Administrative Rules (OARs) and contract requirements with the Oregon Health Authority (OHA) to monitor our network and ensure members can access care promptly. This survey helps us identify member wait times for scheduling appointments and time spend in provider’s offices.
Your accuracy is appreciated, and we may contact you if we have questions about your responses.
EOCCO providers are required to participate in this survey as outlined in the Provider Manual. Please complete it by December 31.
Changes to retroactive authorizations
To align with Oregon Administrative Rule 410-120-1320 (Authorization of Payment), effective with dates of service January 1, 2025, and forward, EOCCO will only accept retroactive authorizations if the following criteria are met.
- The client was made retroactively eligible or was retroactively disenrolled from a CCO or PHP on the date of service; and
- The services provided meet all other criteria and Oregon Administrative Rules; and
- The request for authorization is received within ninety (90) days of the date of service
Any requests for authorization after ninety (90) days from date of service require documentation from the provider that authorization could not have been obtained within ninety (90) days of the date of service.
This means that EOCCO will no longer accept a retroactive authorization if a claim has been denied for no authorization on file. Please contact eoccoproviderinquiry@modahealth.com with any questions or to request additional information regarding this change.
Health-Related Social Needs (HRSN): Nutrition benefit
Effective January 1, 2025, eligible EOCCO members will have access to Medically Tailored Meals (MTM) under the new 1115 Waiver HRSN benefit.
Providers will play a vital role in connecting members with this benefit. Below are the steps to requesting an MTM:
- Member schedules visit with PCP
- Provider refers member to a registered dietician
- Member completes visit with registered dietician and obtains an assessment
- A request for MTM is submitted by filling out the Health-Related Social Needs request form. Members, member representatives, THWs, registered dieticians, PCPs or other support persons may submit this request.
- EOCCO will automatically refer authorized requests to our MTM service provider, Mom’s Meals, for meal delivery
Important: A copy of the registered dietician assessment must be uploaded with the MTM request in order to submit.
PCP Visit, Registered Dietician Assessment and Nutrition Education should be billed to the members EOCCO (medical) plan as normal. If your member has a below-the-line diagnosis and is ineligible for a registered dietician assessment or nutrition education under their medical plan, the following modifiers may be used: U1, U6, UC.
To be eligible, members must first meet the following criteria:
- Be an EOCCO member with EOCCO medical coverage
- Have an HRSN-eligible social risk factor
- Have an HRSN-eligible clinical risk factor
- Be experiencing food insecurity
Access OAR 410-120-2005 Table 2 for more information on nutrition social and clinical risk factors: 410-120-2005.pdf
To learn more about HRSN, visit our Health-Related Social Needs (HRSN) page.
Who is a good candidate for MTM?
- Members recently discharged from hospital setting
- Members with new medical diagnosis
- Members unable to prepare meals independently
- Members needing additional support managing health condition(s)
What kind of meals does Mom's Meals offer for authorized MTM members?
- Diabetes-friendly
- Gluten-free/Celiac-friendly
- Heart-friendly
- Lower sodium
- Pureed
- High protein
- Renal/Kidney-friendly
- Vegetarian
Keep an eye out on the EOCCO website for more nutrition benefit updates coming soon! The nutrition section and request form will be live and available on Jan. 1, 2025.
Questions? Email us at HRSNQuestions@eocco.com
New program launching Jan. 1, 2025: Young Adults with Special Health Care Needs (YSHCN)
A new Oregon Health Plan program, Young Adults with Special Health Care Needs (YSHCN), launches Jan. 1, 2025 for eligible individuals aged 19 and 20. Young adults identified as potential YSHCN members frequently need more health and health-related social services than others of the same age. Providing no-cost health insurance helps these individuals access their regular care during an important time of transition to adulthood.
Benefits:
- Enhanced vision and dental benefits
- Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
- Potential access to Health-Related Social Needs (HRSN) benefits
Eligibility:
Eligible members must meet the following:
- Ages 19 – 20
- Family income up to 205% of the federal poverty level
- Special health care needs, including:
- Physical, intellectual or developmental disabilities
- Chronic conditions like asthma, diabetes or spina bifida
- Behavioral or mental health conditions like depression or substance use disorder
Learn more at the Oregon Health Authority’s website or refer to the OHP Provider Guidance document on how to verify member eligibility.
Linguava interpreter services contract ending Dec. 31, 2024
EOCCO’s contract with Linguava interpreter services will end on Dec. 31, 2024. Certified Languages International will provide direct access to Oregon-qualified and certified healthcare interpreters. More information on how to use this service will be available shortly.
Interpreters through Passport to Languages remain available at no cost to your clinic during the transition and must be prescheduled. For details, visit the EOCCO site.
For questions, please reach out to Courtney.Valenzuela@modahealth.com
EOCCO seclusion and restraint policy
In accordance with Federal law, it is required that EOCCO contracted providers have a policy and procedure regarding the use of seclusion and restraint. On an annual basis, EOCCO requires that all providers attest to this, and beginning in 2024 we are using an electronic survey for providers to respond to. Additional information on EOCCO’s policy on the use of seclusion and restraint is published in the EOCCO Provider Manual.
To submit your 2024 EOCCO Seclusion & Restraint attestation, please visit the online 2024 EOCCO Seclusion Restraint survey
For questions about your entity’s specific annual attestation requirements, please email providerrelations@modahealth.com
IET measure learning collaborative: Thursday, Jan. 23, 2025
Join EOCCO for a virtual learning opportunity focused on the initiation and engagement of substance use disorder treatment (IET) incentive measure.
When: Thursday, Jan. 23, 2025, from 11:30am-1pm PST
Register online here or at bit.ly/IETCollaborative0125
Eligible attendees can earn 1.5 CME credits!
All providers, staff, Traditional Health Workers (THW’s) and Community Health Workers (CHW’s) at any EOCCO-contracted physical and behavioral health practices are encouraged to attend!
2025 calendar year timeline
EOCCO has updated its 2025 calendar with key deliverables and events. These updates include reporting deadlines for items such as Behavioral Health Integration, Language Access Reports and year-end data submissions, along with annual in-person trainings, Community Benefit Investment Reinvestment (CBIR) grant cycles and payment distributions.
To view the full calendar of events
- EOCCO clinical quality measure (CQM) reporting
- Proposal:
- Emails sent to clinics by Friday, Dec. 20, 2024
- Due to EOCCO: Friday, Jan. 17, 2025
- Submission:
- Templates sent: Friday, Feb. 14, 2025
- Due to EOCCO: Friday, March 14, 2025
- Proposal:
- EOCCO prenatal/postpartum care chart review
- Charts sent to clinics: Friday, Feb. 14, 2025
- Due to EOCCO: Friday, March 14, 2025
- EOCCO Q4 2024 language access report
- Templates sent to clinics: Friday, Feb. 14, 2025
Due to EOCCO: Friday, March 14, 2025
Rural Health Care Telecommunications (Telecom) Program
The Telecommunications (Telecom) Program provides funding to eligible healthcare providers for eligible expenses related to telecommunications services essential for delivering healthcare.
This competitive grant is available to:
- Nonprofit hospitals
- Skilled nursing facilities
- Local health departments
- Community mental health centers
- Community health centers
- Post-secondary educational institutions
Funding deadline: April 1, 2025
Learn more: Universal Service Administrative Company
Family Connects Oregon in Malheur County
The Family Connects Oregon program, which provides support and resources to families with newborns, is now available in Malheur County.
Services:
- Public Health Nurse home visits for families welcoming a new baby
- Visits are scheduled around 36 weeks of gestation and occur when the baby is approximately three weeks old
- Health assessments for both parent and baby, answers to new-parent questions and connections to local resources
Cost: No cost for families; services are a continuation of medical care.
Sign up:
- Call: 541-889-7279
Email: familyconnects@malheurco.org
New OHA certified/qualified health care interpreter registry file
The November 2024 Oregon Health Authority (OHA) Health Care Interpreter Registry file is now available on the EOCCO Incentive Measure webpage under “Language Access.”
Features:
- A list of all active OHA-certified or qualified health care interpreters in Oregon
- Downloadable for reference and records
Search the registry online: OHA Health Care Interpreter Registry
Questions?
Questions related to incentive measures, health equity, traditional health workers, SDoH, and HIT - Please email EOCCOMetrics@modahealth.com
Questions related to claims and payment information - Please email EOCCOProviderInquiry@modahealth.com
Need to verify if your provider or group NPI is active? Please use OHA’s verification tool
Need to register your practitioner, group or facility? You can find forms on EOCCO.com/Providers/becomeaprovider
If you would like to be added or removed from the email list, please let us know at finn.gornick@modahealth.com
