FamilyCare Closure: Resources for OMA Members

*Page updated: 05/17/2018*

FamilyCare Transition - Medicare Advantage

In a recent Public Notice, "FamilyCare Announces its exit from Medicare in Tri-County and Clatsop County".  Beginning July 1, 2018 FamilyCare will no longer offer any Medicare Advantage products within the Portland tri-county or Clatsop county areas. FamilyCare's termination request to withdraw from these product offerings was requested of and approved by the Centers for Medicare and Medicaid (CMS).

FamilyCare patients enrolled in: FamilyCare Advantage Rx or FamilyCare Community Plans will need to choose a new plan by June 30, 2018. Those patients who have not taken action to enroll onto a new plan will be covered by original Medicare (FFS), beginning on July 1, 2018.

  • FamilyCare will pay all claims for covered health care services provide on or before June 30, 2018
  • FamilyCare will have a 13 to 18 month wind-down process; this will allow for the processing of claims and appeals and grievances
  • Contact FamilyCare at 866-798-2273 for questions about claims, appeals, or grievances relating to Medicare Advantage services rendered on or before June 30, 2018

Medicare Advantage Resources

FamilyCare Transition - Medicaid 

In December 2017, FamilyCare Health, one of Oregon’s Coordinated Care Organizations (CCOs) serving roughly 115, 000 Oregonians, announced its closure. FamilyCare's contract with the Oregon Health Authority (OHA) ended as of January 31, 2018.  In a media release, OHA indicates that they have begun transferring FamilyCare members to the following three CCOs: Willamette Valley Community Health, Health Share of Oregon, or Yamhill Community Care. OHA anticipates the transition should be completed by February 1.  Below are important resources to assist providers during this transition.

 Medicaid Resources - general

 Medicaid Resources - by Insurer

OHA

HealthShare of Oregon CCO (Multnomah, Clackamas, Washington Counties)

  1. Behavioral Health Provider Resources

    2. Physcial Health Provider Resources

            -Healthshare: providers@healthshareoregon.org

           -CareOregon: newcontractrequest@careoregon.org

           -Providence:  PHPProviderContracting@providence.org

           -Kaiser: 503-813-2000

           -Tuality: erin.blume@tuality.org

     3. Patient (HealthShare member) Resources

Yamhill Community Care Organization (Washington County)

  • Main website 
  • Family Care Transition update statement - January 5, 2018
  • Contact Yamhill CCO: 855-722-8205, ext. 3

Willamette Valley Community Health CCO (Marion County)

  • Main website
  • Contact Willamette Valley Community Health CCO: 1-503-587-5123

 FamilyCare CCO

 

 

 

 

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