EOCCO Clinics & Staff,
Welcome to the February 2025 issue of the EOCCO monthly newsletter. Below is a preview of the articles you will find in this month's email:
News From EOCCO:
- Provider DMAP revalidation
- Health-related social needs (HRSN): Nutrition benefit
- EOCCO 2025 Quality Improvement office hours
- EOCCO 2025 Incentive Measure guide
- Reminder: changes to retroactive authorizations
- EOCCO New Ideas and SHARE grant programs now accepting applications
- New OHA-Certified/Qualified Health Care Interpreter (HCI) Registry file posted
- Spanish health care interpreter course launching soon!
- Engaging patients with type II diabetes webinar
- Diabetes care for whole person health
- Rural Population Health Incubator Program
Please contact: EOCCO Provider Inquiry
Thank you,
Your EOCCO Team
Provider DMAP revalidation
The 2025 Medicaid DMAP revalidation period has begun, and a portion of the EOCCO network has been identified for revalidation.
If you enrolled or re-enrolled in 2024, you likely will not appear on this list. For those who do, we will require completed forms and accompanying documentation, such as individual practitioner licensure or clinic/group W-9s.
Action item:
- Please check this page to find/enter your NPI to see if an individual provider or clinic needs to be revalidated: Provider DMAP revalidation lookup
- If you are still unsure whether you need to complete this process, feel free to contact us at providerDMAPApps@modahealth.com. When emailing us, please use the subject line “2025 Medicaid DMAP Revalidation” so we may properly expedite your emails/applications
Please note:
- The deadline for revalidation is March 31, 2025
- We will do our best to do individual outreach and follow-up if we do not receive applications prior to the deadline
- If revalidation is not completed by this date, claims may begin to deny due to a lack of DMAP registration
- If this occurs, contact us immediately so we can assist with re-enrollment, backdate your registration, and reprocess claims
We appreciate your patience as we work to make this process as seamless as possible for everyone involved.
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 and obtains referral to a registered dietician.
- 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: Introduction. (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 normally would bill.
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
- Experiencing food insecurity
For more information on nutrition, social and clinical risk factors, download the HRSN OAR Information PDF and view OAR 410-120-2005 Table 2
Learn more about HRSN, visit our Health-Related Social Needs (HRSN) | EOCCO Provider.
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
EOCCO 2025 Quality Improvement office hours
The EOCCO Quality Improvement (QI) team is hosting a QI office hours series in 2025! These office hours will be hosted monthly and are intended to support our clinical partners in impacting CCO incentive measure performance and meeting state/EOCCO reporting requirements. The office hours are also an opportunity to meet other clinical peers from across Eastern Oregon.
The first portion of each office hour session will loosely focus on a particular incentive measure, reporting requirement, or initiative relevant to EOCCO’s clinical partners. However, all office hours are a space where staff or providers can come to ask questions and peer-share about anything quality- or incentive measure-related.
QI office hours schedule:
- Second Tuesday of every month from 11:00 a.m.-12:00 p.m. PST (beginning March 2025)
Please complete the QI office hours registration form to indicate your interest in participating in EOCCO’s QI office hours.
We will send out the calendar invite for the full QI office hours meeting series once registration is received. Please reach out to EOCCOmetrics@modahealth.com with any questions.
EOCCO 2025 Incentive Measure guide
The 2025 Incentive Measure guide has been posted to the EOCCO website. This guide outlines the specifications that the Oregon Health Authority (OHA) has set for each incentive measure, along with guidance on coding and improvement strategies.
A few notable changes and key takeaways for 2025 are outlined below:
New Incentive Measure
There is one new incentive measure for 2025, which is the Child-Level Social-Emotional Intervention/Treatment Services. This is a claims-based measure that captures the percentage of patients aged 1-5 who receive an issue-focused social-emotional health intervention or treatment service during the measurement year. This measure builds upon the systems-level work that EOCCO, clinicians and community partners have been engaging in over the past three years to expand access to social-emotional and behavioral health services for young children and their families that are a best match for their needs.
Cigarette smoking prevalence and SBIRT
These clinical EHR-based measures were removed from the 2025 CCO incentive measure set by OHA and are no longer included in the Incentive Measure guide.
Social Needs Screening and Referral
Clinical reporting for the Social Needs Screening and Referral incentive measure will begin in 2025. For 2025, OHA will provide a random sample ("hybrid sample") of 1,067 adult and pediatric EOCCO patients. Clinics will be asked to report social needs screening and referral data for their assigned patients included in the sample.
Challenge Pool
Challenge Pool measures represent priority healthcare and quality improvement areas at the state level and, if met, provide additional funding to CCOs and, in turn, its provider and community partners. The following measures have been selected for the 2025 Challenge Pool:
- Preventative Dental Services ages 1-5 and 6-14
- Well Care Visits ages 3-6
- Timeliness of Prenatal and Postpartum Care
- Diabetes HbA1c Poor Control
Note that the 2025 incentive measure improvement targets are based off of EOCCO’s prior-year measure performance and will be calculated by OHA in June of 2025. EOCCO will update the 2025 Incentive Measure guide mid-year to include measure-specific targets.
Thank you for taking the time to review the 2025 Incentive Measure changes. Please don’t hesitate to reach out to the EOCCO Quality Improvement team at EOCCOmetrics@modahealth.com with any questions or concerns.
Reminder: changes to retroactive authorizations
To align with Oregon Administrative Rule (OAR) 410-120-1320 (Authorization of Payment), effective with dates of service Jan. 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. Please contact eoccoproviderinquiry@modahealth.com with any questions or to request additional information regarding this change.
EOCCO New Ideas and SHARE grant programs now accepting applications
EOCCO offers several grant programs to improve the health and quality of life for Eastern Oregonians. These grant programs aim to fund services that are not already covered by health insurance. There are two grant opportunities that are currently accepting applications:
New Ideas application
The Community Benefit Initiative Reinvestment (CBIR) New Ideas application allows applicants to propose novel ideas focused on incentive measures, collaboration, telehealth and broadband capacity, behavioral health integration, workforce strategies, and addressing health disparities. Up to $50,000 is available per grantee. If you are interested in submitting a proposal, you can find the CBIR New Ideas application on the EOCCO Grants website. All applications must be submitted by March 31, 2025. The funding cycle runs from January to December. This application reopens every six months.
Supporting Health for All through Reinvestment (SHARE)
Applications are now open for the 2025 Supporting Health for All through Reinvestment (SHARE) program. Funding supports projects that address Social Determinants of Health and Equity (SDOH-E), such as housing, food, transportation, safety and more.
Eligible applicants include SDOH-E partner organizations that deliver services, programs, or support policy and systems change within EOCCO’s service area. The length of projects can range from one to three years. SHARE project applications can request between $15,000 to $250,000.
Applicants are required to obtain free technical assistance as they develop their proposal. The following technical assistance webinars are scheduled to learn more about the SHARE application and answer general questions:
- Thursday, Feb. 20, 2025, from 11:00 a.m.-12:00 p.m.
- Wednesday, March 5, 2025, from 12:00-1:00 p.m.
- Friday, March 14, 2025, from 2:00-3:00 p.m.
Please contact EOCCOGrants@eocco.com for 1-on-1 technical assistance.
SHARE applicants are required to submit their proposals by March 28, 2025. Given the complex nature of social determinants of health projects and limited number of awards, not all project proposals may be selected for funding.
For more information, visit the EOCCO Grants website.
New OHA-certified/Qualified Health Care Interpreter Registry file posted
The December 2024 OHA Health Care Interpreter (HCI) Registry file has been posted to the EOCCO Incentive Measure webpage under “Meaningful Language Access.” This file contains a list of all active OHA-certified or Qualified Health Care Interpreters in the state of Oregon. This file can be downloaded for your reference and records.
You can also search for OHA-certified or Qualified Health Care Interpreters on the Health Care Interpreter Registry webpage.
Spanish health care interpreter course launching soon!
Oregon State University (OSU) is preparing for their spring Spanish-English Health Care Interpreter training program, which will take place from April 11 to June 13, 2025. The course will teach students about interpreting in a medical setting and prepare them to become an Oregon-qualified or certified interpreter.
This eight-week/64-hour course requires online and in-person coursework. The course requires students to attend three in-person sessions and two live Zoom sessions to help facilitate interpreting skills. In-person sessions will be held at the OSU extension center in Ontario, Oregon. See the OSU Continuing Education website for the full schedule.
Prerequisites: Much of the instruction will be taught in Spanish. Before enrolling in the course, students will need to demonstrate proficiency in both English and Spanish. Proficiency can be met by:
- Providing a copy of their degree, GED or transcripts, or
- Passing a proficiency test. Proficiency tests can be ordered when signing up for the course on the OSU website. (Plan ahead! Requesting a test will need to be booked ahead of time. We recommend requesting this test no later than March 14.)
Students who live or work in one of the twelve counties served by EOCCO are eligible for a discounted tuition rate. For more information or to apply, visit OSU Continuing Education.
Engaging patients with type II diabetes webinar
Join the Oregon ECHO Network for a one-hour webinar where experts Eric Wiser, MD, and Mike Farley, RPh, will share about how we talk about diabetes, harm reduction and goal setting, and simplified medical interventions for patients with type II diabetes.
When: March 6, 2025, from 12:00 - 1:00 p.m. PST
Need to know:
- Earn one credit of CME
- One-time only!
- Time for Q&A – bring your questions for our experts
- Presented in English; translation available upon request (request via registration portal)
Please click here to register for this webinar on engaging patients with type II diabetes. Email oen@ohsu.edu with any questions or accommodations.
Diabetes care for whole person health
This 12-session educational series by the Oregon ECHO network enhances the ability of primary care clinicians and healthcare team members to effectively manage diabetes and its complications.
Topics include:
- Diabetes care teams in diverse settings
- Patient and community engagement
- How systemic racism and social determinants of health impact patients with diabetes
- Identification and management of diabetes complications and comorbidities
- Cost-effective and evidence-based medication management strategies
Audience: Physicians, physician assistants, nurse practitioners, pharmacists, social workers, traditional health workers, and administrative staff among others
When: Wednesdays from 7:30-8:30 a.m. PST, from April 2–June 18, 2025
Please click here to register for this 12-session series on diabetes care for whole person health!
Rural Population Health Incubator Program
The Rural Population Health Incubator Program (the Incubator) provides grants to support population health and health equity programs initiated by rural hospitals, clinics, public health departments, and/or rural, community-based nonprofit organizations in Oregon.
Through this program, grantees will:
- Receive up to a $10,000 grant to support their population health program
- Join a cohort of other Incubator grantees and attend three cohort meetings throughout the grant cycle, and
- Receive specialized support from the Oregon Office of Rural Health (ORH), including resources, information and referrals to experts to assist their program
Proposals are due April 11, 2025. For more information or to sign up for an informational webinar, please visit OHSU's Rural Population Health Incubator Program website.
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
