Network changes for therapy related services (Acupuncture – Chiropractic – Physical, Occupational and Speech therapy) – as of 1/1/21
We appreciate the relationship that you have established and the care that you have provided to our members in the past. In order to maintain an efficient provider network that ensures alignment with Coordinated Care Organization (CCO) goals, CareOregon will be ending our current practice of paying non-contracted: physical therapy, speech therapy, occupational therapy, acupuncture and chiropractor providers that serve our Medicaid members. This change does not apply to dual-eligible members on CareOregon Advantage. For CareOregon Advantage the existing prior-authorization rules for these services still apply.
A managed/optimized provider network makes it possible to focus care coordination for members while ensuring adequate access to needed services. This change helps strengthen the collaborative partnership between CareOregon and contracted providers. Contracted providers have access to CareOregon resources and programs to help navigate care delivery for our members/ best possible care.
Effective for dates of service on or after January 1, 2021, we will no longer be reimbursing non-contracted providers for services rendered to Health Share of Oregon/CareOregon, Jackson Care Connect or Columbia Pacific CCO Medicaid members. Requests submitted by non-contracted providers for dates of service in 2021 will not be processed. Members may not be billed for covered services that are denied for non-compliance with CCO administrative rules.
Our physical therapy, occupational therapy and speech & hearing therapy network is managed by North West Rehab Alliance (NWRA). Please connect with them for possible contracting. Any other contracting inquiries should be directed to CareOregon at newcontractrequest@careoregon.org. We are providing advanced notice to both our members and non-contracted providers, to allow ample time for a safe transition of any care to a contracted network provider.
Members can refer to their respective CCO’s online provider directory for a current list of contracted providers they can switch to. Members can also call their CCO’s Customer Service Department or their PCP for help finding a new contracted provider.
Health Share of Oregon/CareOregon: careoregon.org/find-a-provider
Customer Service: 800-224-4840
Columbia Pacific CCO: colpachealth.org/providerdirectory
Customer Service: 855-722-8206
Jackson Care Connect: jacksoncareconnect.org/providerdirectory
Customer Service: 855-722-8208
If you have questions about this change, please contact CareOregon Provider Customer Service at 800-224-4840, Monday through Friday, 8 a.m. to 5 p.m
Vice President, Network & Clinical Services
