Oregon Administrative Rules › Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS › Division 141 - OREGON HEALTH PLAN › Section 410-141-3575 - MCE Member Relations: Marketing

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following definitions apply for
			 purposes of OAR 410-141-3575  through 410-141-3585:
(a) "Alternate Format" means any alternate
			 approach to presenting print information to an individual with a disability.
			 This term includes, at a minimum, the types of alternate formats defined under
			 the Americans with Disabilities Act (ADA) and  45 CFR Part 92, and shall
			 include: braille, large (18 point) print, audio narration, oral presentation,
			 electronic file, sign language interpretation, and sighted guide;
(b) "Cold-call Marketing" means any
			 unsolicited personal contact with a potential member for the purpose of
			 marketing by the MCE;
(c)
			 "Marketing" means any communication from an MCE to a potential member who is
			 not enrolled in the MCE that can reasonably be interpreted as intended to
			 compel or entice the potential member to enroll in that particular
			 MCE;
(d) "Marketing Materials"
			 means materials that are produced in any medium by or on behalf of an MCE and
			 that can reasonably be interpreted as intended to market to potential
			 members;
(e) "Outreach" means any
			 communication from an MCE to any audience that cannot reasonably be interpreted
			 as intended to compel or entice a potential member to enroll in a particular
			 MCE. Outreach activities include, but are not limited to, the act of raising
			 the awareness of the CCO, the MCE's subcontractors and partners, and the MCE
			 contractually required programs and services; and the promotion of healthful
			 behaviors, health education and health related events. For full benefit dual
			 eligible (FBDE) members, outreach to provide information about opportunity to
			 align Medicare and Medicaid benefits, or CMS approved Default or Simplified
			 enrollment for newly Medicare eligible member in the CCO regarding MA or DSNP,
			 is allowable subject to OHA or CMS materials review.
(f) "Outreach Materials" means materials that
			 are produced in any medium, by or on behalf of an MCE that cannot reasonably be
			 interpreted as intended to compel or entice a potential member to enroll in a
			 particular MCE;
(g) "Potential
			 Member" means, as defined in OAR 410-141-3500, a person who meets the
			 eligibility requirements to enroll in the Oregon Health Plan but has not yet
			 enrolled with a specific MCE;
(h)
			 "Prevalent Non-English Language" means all non-English languages that are
			 identified during the eligibility process as the preferred written language by
			 the lesser of:
(A) Five percent of the MCE's
			 total OHP enrollment; or
(B) One
			 thousand of the MCE's members;
(i) "Readily Accessible" means electronic
			 information and services that comply with modern accessibility standards such
			 as section 508 guidelines, section 504 of the Rehabilitation Act, and W3C's Web
			 Content Accessibility Guidelines (WCAG) 2.0 AA and successor
			 versions.
(j) "Written Member
			 Materials" means informational and educational communications for members or
			 potential members that are produced by or on behalf of an MCE in any written
			 medium, including but not limited to: letters, brochures, guides, scripts,
			 email, and text messaging. All written member materials must comply with the
			 Authority's formatting and readability standards, as described in OAR
			 410-141-3585  and 42 CFR
			 §
										438.10, and be written in plain
			 language sufficiently clear that a layperson could understand the
			 information.