Oregon Senate Bill 1529 – Important new Primary Care Provider requirement for Oregon members

Members on Oregon based plans must choose, or be assigned to, a Primary Care Provider (PCP) for themselves and each covered dependent, based on Oregon Senate Bill 1529.

The Oregon Senate Bill (SB) 1529 introduced new requirements for the administration of health care benefits. Under this bill, Oregon health plans, including Providence Health Plan, are required to assign a Primary Care Provider (PCP) to members who live in Oregon within 90 days of enrollment.

What this means for members:

Providence Health Plan is required to have existing members assigned in our system by July 1, 2024 and members may choose their PCP if desired. This will impact all Individual and Family lines of business and Fully-Insured Small Group & Large Groups that have addresses in Oregon.

Why this matters:

PCPs play a critical role helping patients manage their health. They establish a close relationship with their patients, so they fully understand their health history and they often help assemble a team of specialists to make sure every aspect of a patient’s needs are met. This bill marks an important change, one that will help make care more accessible for Oregon residents.

Important note

Members will be communicated with directly and do not need to do anything until they receive a letter from us. That letter will include specific directions on what actions are needed.

Providence Health Plan is rolling this out in a phased approach so some members could receive communication as early as May, others may not hear from us until later this year.

 

Need to find a Primary Care Provider? 

 
Take a look at our Provider Directory by visiting ProvidenceHealthPlan.com/FindAProvider. For tips on how to best find an in-network provider based on your needs, download or view this flyer.

Here’s what you need to know – frequently asked questions:

  • What is Senate Bill 1529
    • All members must have an assigned Primary Care Provider (PCP) due to Oregon Senate Bill 1529.
    • It requires Oregon health plans, including Providence Health Plan, to assign a PCP to members who live in Oregon within 90 days of enrollment.
    • This requirement is required for both new and existing Providence Health Plan members.
  • What does choosing a PCP or being assigned to a PCP mean?
    • The important thing to know is this does not change your benefits or coverage. You can still see any in-network provider that’s outlined by your health plan benefits.
    • Through this choice or assignment, you may be contacted by your PCP to engage in certain healthcare activities (e.g. annual visits, screenings).
  • Can members change the PCP they’re assigned to?
    • Yes! At any time. Call Customer Service at 503-574-8201, 8 a.m. to 5 p.m. (Pacific Time), Monday through Friday.
    • Later this year, you will also be able to make changes to your PCP selection or assignment in your myProvidence account.

Sign up for a myProvidence account today

Visit myProvidence.com and be sure to have the Member ID for you and any of your dependents. Download or view this flyer (English or Spanish) for more specific instructions on how to sign up.

Have additional questions?
 

Members

Call Customer Service at 503-574-8201, 8 a.m. to 5 p.m. (Pacific Time), Monday through Friday.

Producers and Employers

Please contact your account manager for more details.

Need help?

Hey!

You are now leaving the Providence Medicare Advantage Plans website. Are you sure thats what youd like to do?

No, I'll stay Yes, I'm leaving