ORS 192.395
Health services costs
(1)
The amounts determined by an independent actuary retained by the agency to cover the costs of providing each of the following health services under ORS 414.591 (Coordinated care organization contracts), 414.631 (Mandatory enrollment in coordinated care organization) and 414.688 (Commission established) to 414.745 (Liability of health care providers and plans) for the six months preceding the report:(a)
Inpatient hospital services;(b)
Outpatient hospital services;(c)
Laboratory and X-ray services;(d)
Physician and other licensed practitioner services;(e)
Prescription drugs;(f)
Dental services;(g)
Vision services;(h)
Mental health services;(i)
Chemical dependency services;(j)
Durable medical equipment and supplies; and(k)
Other health services provided under a coordinated care organization contract under ORS 414.591 (Coordinated care organization contracts) or a contract with a prepaid managed care health services organization, as defined in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414);(2)
The amounts the agency and each contractor have paid under each coordinated care organization contract under ORS 414.591 (Coordinated care organization contracts) or prepaid managed care health services organization contract for administrative costs and the provision of each of the health services described in subsection (1) of this section for the six months preceding the report;(3)
Any adjustments made to the amounts reported under this section to account for geographic or other differences in providing the health services; and(4)
The numbers of individuals served under each coordinated care organization contract or prepaid managed care health services organization contract, listed by category of individual. [Formerly 192.493]
Source:
Section 192.395 — Health services costs, https://www.oregonlegislature.gov/bills_laws/ors/ors192.html
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