OR HB2238

Extends coordinated care organization (CCO) contracts with the Oregon Health Authority from 5 years to 10 years, with a reevaluation option after the initial 5 years if a CCO is not in good standing.

Restricts contract amendments to once per 12-month period and requires 45 days' notice for proposed changes, with final guidance issued at least 60 days before changes take effect.

Establishes a service area entry assessment process requiring CCOs to meet specific conditions before expanding into areas already served by other CCOs, including failure to meet access quality measures for 5 of the last 20 quarters or network adequacy standards.

Directs the Oregon Health Authority to establish a minimum medical loss ratio for CCOs consistent with federal requirements under 42 C.F.R. 438.8 and to study barriers to CCO global budget operations by December 15, 2026.

Applies health outcome and quality measure reporting requirements to fee-for-service medical assistance providers, not just CCOs and commercial health plans.