As we prepare for the changes coming from the state in Medicaid coverage for 2020, we wanted to update you on the latest information.
- This week, we received a file from the Oregon Health Authority with the list of about 12,000 members who will be reassigned to Jackson Care Connect on January 1, 2020. We are working with AllCare to identify the existing primary care providers for those members. We will provide those lists to clinics who have members affected by this change.
- Although members will be with Jackson Care Connect effective January 1, they may not receive their new ID cards by January 1, due to some delays in the data files from OHA. Please note your clinic may have to look up members to verify coverage in this transition. You can look up eligibility on MMIS or CareOregon Connect. Please call Jackson Care Connect Customer Service at 855-722-8208 if you have any questions.
- When billing, please remember to check OHP eligibility for the date of service. If you receive a denial from one CCO because the member was not covered on that date of service, please check to be sure that the patient’s CCO hasn’t changed. Remember that you may not bill OHP members for services covered by OHP.
- There are some key differences in the Jackson Care Connect and AllCare formularies. All previous prior authorizations and prescriptions will continue to be covered for up to 60 days. Please download this document for specific details on both pharmacy prior authorizations and formulary differences.
- Throughout this transition time, we are working with AllCare and OHA to transition members as smoothly as possible, with minimal disruption. Our first priority is to support OHP members and our provider partners at the highest level.
- OHA will host a webinar on January 15, 2020 specifically for providers in Jackson County, to cover questions you may have on this transition. Look for more information in the OHA Provider Matters newsletter.
- Finally, as a reminder, please note CCO changes do not affect Medicare patients. The member reassignment is for OHP/Medicaid only.
Thank you for your continued commitment to serving OHP members, and for your patience throughout this transition.