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Laws and Rules Governing the Health Policy and Analytics Division

The laws governing the activities and scope of the Health Policy and Analytics Division (HPA) are defined in the Oregon Revised Statutes (ORS). The Oregon Administrative Rules (OAR) determine how those laws will be implemented. Learn more from the State Legislative website and the Secretary of State website.

Current Rulemakings

Proposed Permanent Rulemakings

The Oregon Health Insurance Marketplace empowers Oregonians to improve their lives through local support, education, and access to affordable, high-quality health coverage by:

  • Overseeing the health insurance products sold to Oregonians through HealthCare.gov.
  • Providing free, local enrollment assistance to Oregonians.
  • Raising awareness among consumers about health insurance options available in Oregon.
  • Working with carriers, agents, community partners, and other stakeholders to get more people enrolled.
  • Training and certifying community partners to be able to provide choice counseling services to Oregonians.
Following Oregon's transition to a state-based marketplace, the Marketplace will assume responsibility for:​
  • Facilitating and managing applications submitted through the state-based marketplace platform.
  • Training and certifying insurance agents to guide Oregonians through the application and enrollment process.
  • Providing constituent services for escalated case issues, problem solving, and handling appeals.
  • Assessing enrollment data to inform health coverage policy decisions, systemic improvements, and outreach strategy.
  • Training for, managing and facilitating consumer support through the state consumer assistance center.

​Notice of Proposed Rulemaking Tracked Changes

Public Comment Period: September 1, 2026 – September 21, 2026
Public Hearing: September 17: 2:00-3:00 p.m. See meeting details in the Notice of Proposed Rulemaking link above.
Last Day for Public Comment: 5 p.m. September 21, 2026.

You can submit public comment in a variety of ways:

  • Provide written or oral comments on the rule at the Rulemaking Hearing
  • Send written email comments to: Victor.Garcia@oha.oregon.gov
  • Telephone comments: 
  • Mail your comment to:
Victor Garcia
500 Summer St. NE
Salem, OR 97301




The Oregon All Payer All Claims (APAC) Reporting Program has been integral to Oregon's health system transformation since it was established in 2009. It contains administrative health care data on topics such as insurance coverage, health service cost and utilization for Oregon's insured populations. APAC provides access to timely and reliable data essential to assess the cost of health care, improve quality, reduce costs and promote transparency. 

The purposes of APAC are described in statute (ORS 442.373) and include:

  • Allowing health care policymakers to make informed choices
  • Improving the quality and affordability of health care and health care coverage
  • Comparing the costs and effectiveness of treatment settings and approaches
  • Providing information to consumers and purchasers of health care
​

Notice of Proposed Rulemaking 

Public Comment Period: 

Last Day for Public Comment: 5 p.m. 

You can submit public comment in a variety of ways:

  • Provide written or oral comments on the rule at the Rulemaking Hearing
  • Send written email comments to: Grace.Paiva@oha.oregon.gov
  • Telephone comments: 971-283-5279
  • Mail your comment to:
    Grace Paiva
    800 NE Oregon St. Ste 730
    Portland, OR 97232

Public Hearing: to be added later

Notice of Proposed Rulemaking​ - to be added later

Hearing Recording - to be added later


Adopted Rules

HPA Rules by CHAPTER NUMBER

Chapter 409 - Health Policy and Analytics
Chapter 431 - Oregon Prescription Drug Program (OPDP)
Chapter 945 - Oregon Health Insurance Marketplace

HPA Rules by SUBJECT CATEGORIES

HPA rules basically fall into three categories: 1) Commissions; 2) Data Reporting, and 3) Programs. The links below provide additional information not found on the Secretary of State's website, including:

  • Rule (current and upcoming)
  • Attachments, tables, forms (if applicable)
  • Applicable statutes (ORS) that govern the rule
  • Program website

Commissions

Rule: ​OAR 409-060
Applicable statutes
Commission website

OAR 409-060 includes the following rules:

  • 409-060-0100 Scope
  • 409-060-0110 Definitions
  • 409-060-0120 HERC Process for Evidence-based Reports
  • 409-060-0130 Medical Technology Assessments
  • 409-060-0140 Evidence-based Guidelines
  • 409-060-0150 Coverage Guidelines

Rule: OAR 409-050
Applicable Statutes
Commission Website

OAR 409-050 includes the following rules:

  • 409-050-0100 Purpose
  • 409-050-0110 Definitions
  • 409-050-0120 Commission Positions
  • 409-050-0130 Pain Management Education Program Requirements

Data Reporting Rules

Most hospitals in Oregon are recognized as non-profit institutions. To maintain their tax-exempt status, non-profit hospitals are expected to provide measurable benefits to the communities they serve. Community benefits generally are defined as programs or activities that hospitals provide despite a low or negative financial return. Examples of community benefits include providing free or discounted care to persons living in poverty, conducting education or research to promote community health, or donating funds or services to community groups.
 
In 2007, HB 3290 established Oregon's community benefit reporting law in order to document the benefits that hospitals provide to their communities. Under this law, each hospital annually submits a form to the Oregon Health Authority that reports the hospital's cost of providing community benefits in various categories​.

Program Website​

OAR 409-023 consists of the following rules:

  • 409-023-0100 Definitions
  • 409-023-0105 Community Benefit Reporting
  • 409-023-0110 Community Benefit Minimum Spending Floor
  • 409-023-0115 Annual reports of financial assistance policies and nonprofit status
Permanent Administrative Order
​
Effective Date: July 1, 2026

Permanent Rule
Permanent Rule Tracked Changes​
Public Comment Report
Public Hearing Recording​



Rule: OAR 409-021
Applicable Statutes

OAR 409-021 includes the following rules:

  • 409-021-0005 Introduction
  • 409-021-0010 Definitions
  • 409-021-0115 Calculations of Fees
  • 409-021-0120 Inspection of Health Data
  • 409-021-0130 Requests to Obtain Copies of Public Use Health Data Files
  • 409-021-0140 Requests & Requirements to Obtain Restricted Health Data Sets
  • 409-021-0150 Denial of Requests to Inspect or Obtain Copies of Health Data

Program Website:  https://stage.oregon.gov/oha/HPA/ANALYTICS/Pages/All-Payer-All-Claims.aspx

OAR 409-028 includes the following rules: includes the following rules:

  • 409-028-0000 Purpose and Scope
  • 409-028-0010 Definitions
  • 409-028-0020 Coordinated Care Organization (CCO) Reporting Requirements​
Health Policy & Analytics has filed notice with the Secretary of State to repeal rules for the Primary Care Payments program. Please consult the notice for more information:





Rule: ​OAR 409-024
Applicable Statutes
Program Website

 OAR 409-024 includes the following rules:

  • 409-024-0000 Definitions
  • 409-024-0110 Capital Project Report
  • 409-024-0120 Public Comments
  • 409-024-0130 Civil Penalties

​Rule: OAR 409-026
Applicable Statute
Program Website

OAR 409-026 includes the following rules:

  • 409-026-0100 Definitions
  • 409-026-0110 Data Elements
  • 409-026-0120 Reporting Schedule and Format
  • 409-026-0130 Fees
  • 409-026-0140 Data Access

Rule: OAR 409-015
Applicable Statutes
Program website

OAR 409-015 includes the following rules:

  • ​409-015-0005 Definitions
  • 409-015-0010 Report Forms
  • 409-015-0012 Filing Date
  • 409-015-0015 Reports Required
  • 409-015-0030 Modification of Reporting Requirements
  • 409-015-0035 Civil Penalties

​Rule: OAR 409-022
Applicable Statutes: ORS 442.370​

OAR 409-022 includes the following rules:

  • 409-022-0010 Definitions
  • 409-022-0015 Health Care Facility Annual Reports
  • 409-022-0020 Hospital Reporting Requirements
  • 409-022-0025 Ambulatory Surgical Centers Requirements
  • 409-022-0035 Ambulatory Surgical Center Fees
  • 409-022-0060 Access to Health Data
  • 409-022-0070 Health Care Facility Utilization and Discharge Data Use and Disclosure

Programs

​The statewide set of administrative requirements for students to training in clinical settings was established over a decade ago. Since that time substantial changes in the health care system have continually changed, including the manner in which education is conducted, and an expansion of health profession disciplines that rely on clinical training for completion of educational requirements. OAR 409-030 calls for annual review and changes to the standards if required. OHA has convened an advisory group as required under rule. The group, which includes students, educators, and health care organization leaders, has provided feedback to OHA on a revision to the current rules to adjust to current times.​

Program Website

OAR 409-030 includes the following rules:

  • 409-030-0100 Purpose
  • 409-030-0110 Definitions
  • 409-030-0120 General Applicability
  • 409-030-0130 Health Professional Disciplines
  • 409-030-0140 Clinical Settings
  • 409-030-0150 Exceptions
  • 409-030-0160 Regular Review of Clinical Standards
  • 409-030-0170 Administrative Requirements for Clinical Placement
  • 409-030-0180 Immunization Standards
  • 409-030-0190 Screening Standards
  • 409-030-0200 Tuberculosis Screening
  • 409-030-0210 Drug Testing for Substance Abuse and Misuse
  • 409-030-0220 State and Nationwide Criminal Background Checks
  • 409-030-0230 Training Standards
  • 409-030-0240 Insurance and Liability Coverage
  • 409-030-0250 Information Sharing or Use of Data

​Notice of Proposed Rulemaking​
Public Hearing Recording
Public Comment Report​
​Permanent Rule
Permanent Rule Tracked Changes​


​The HCMO program is currently conducting rulemaking. Please consult their HCMO program rulemaking page​ for full details.​

Permanent Rule
Permanent Rule Tracked Changes
Hearing Recording
Public Comment Report​

The agency revised its rules to update incentive program descriptions based on external partner and internal recommendations. The rule changes will improve accessibility and clarity in understanding incentive requirements and better reflect the current landscape of the health care workforce. Additionally, the changes will embed stronger equity and inclusion language to better align with the needs of populations served by this rule, including those in the health care workforce that deliver care to those experiencing the greatest inequities.

​OAR 409-036 includes the following rules:

  • 409-036-0000 Purpose and Scope
  • 409-036-0010 Definitions
  • 409-036-0020 Types of Incentives Offered under the Program
  • 409-036-0030 Eligibility Criteria specific to Loan Repayment Subsidies
  • 409-036-0040 Eligibility Criteria specific to Scholarships for Students in Health Professional Training Programs at Other Institutions of Higher Learning
  • 409-036-0050 Eligibility Criteria and Program Requirements specific to Medical Malpractice Insurance Program Subsidies
  • 409-036-0060 Participation and Application Requirements
  • 409-036-0070 Application and Review Process
  • 409-036-0080 Maximum Award Amounts
  • 409-036-0090 Transfer of Provider Service Obligation to Another Site
  •  409-036-0100 Suspension of Waiver of Provider Service Obligation
  • 409-036-0110 Monitoring and Follow-up Requirements
  • 409-036-0120 Failure to Comply; Penalties & Appeals
  • 409-036-0130 Contributions to the Health Care Provider Incentive Fund
  • 409-036-0140 Program Integrity
  • 409-036-0150 Data Sharing

Program Website

​Effective Date: July 1, 2026

Public Comments
Public Hearing Recording​

  • Date: April 17th, 2026   Time: 12:00 p.m.

Public Comment Report

Rules Advisory Committee (RAC) Meeting Recordings

Between November 2025 and January 2026, the Oregon Health Authority engaged a Rules Advisory Committee (RAC) to seek feedback and recommendations related to the rule changes. Recordings from the RAC meetings are listed below.

The Oregon Health Authority, Health Policy & Analytics Division has filed the following notice of proposed rulemaking. Please consult this linked notice for details:

OAR 409-026 October 202​5 Notice of Proposed Rulemaking​

Permanent Administrative Order

Permanent Administrative Order Tracked Changes

A public rules hearing was held online for this proposal on October 15 at 2:05 pm, click here to view the recording​. Written comments were due by 5 pm on October 21, 2025, the program is now reviewing comments. 



Rule: OAR 409-045
Application Forms: Credentialing / Recredentialing
Applicable Statutes
Program Website

OAR 409-045 includes the following rules:

  • 409-045-0025 Definitions
  • 409-045-0030 Oregon Common Credentialing Program
  • 409-045-0035 Oregon Practitioner Credentialing Application
  • 409-045-0040 Credentialing Information Verifications
  • 409-045-0045 Health Care Regulatory Board Participation
  • 409-045-0050 Credentialing Organization Participation
  • 409-045-0055 Health Care Practitioner Participation
  • 409-045-0060 Use of Health Care Practitioner Information
  • 409-045-0065 Common Credentialing Advisory Group
  • 409-045-0070 Imposition of Fees
  • 409-045-0075 Complaints
  • 409-045-0115 Telemedicine Providers General Applicability Credentialing Requirements
  • 409-045-0120 Telemedicine Providers Standard List of Credentialing Documents
  • 409-045-0125 Telemedicine Providers Distant-Site Hospital Agreements
  • 409-045-0130 Telemedicine Providers Hold Harmless Clause
  • 409-045-0135 Telemedicine Providers Information Sharing or Use of Data

​Rule: ORS 431-121
Applicable Statutes
Program website

OAR 431-121 contains the following rules:

  • 431-121-2000 Definitions
  • 431-121-2005 General Administration
  • 431-121-2010 Pharmacy Providers
  • 431-121-2020 Program Price
  • 431-121-2030 Preferred Drug List
  • 431-121-2050 Enrollment
  • 431-121-2065 Contracted Services

​Rule: OAR 409-055
Attachment: Tables 1-4
Applicable Statutes
Program Website

OAR 409-055 contains the following rules:

  • 409-055-0000 Purpose & Scope
  • 409-055-0010 Definitions
  • 409-055-0020 Program Administration
  • 409-055-0030 Practice Application & Recognition Process
  • 409-055-0040 Recognition Criteria
  • 409-055-0045 5 STAR Designation
  • 409-055-0050 Data Reporting Requirements for Recognized PCPCHs
  • 409-055-0060 Verification
  • 409-055-0070 Compliance
  • 409-055-0080 Insurance Carrier, Managed Care Plan & Public Stakeholder Communication
  • 409-055-0090 Reimbursement Objectives

​Rule: 409-035
Applicable Statutes
Program Website

OAR 409-035 contains the following rules:

  • 409-035-0000 Purpose
  • 409-035-0010 Definitions
  • 409-035-0020 Health Care Facility Participation Requirements
  • 409-035-0030 Physician Participation Requirements
  • 409-035-0040 Application Review Process
  • 409-035-0050 Monitoring and Follow-up Requirements
  • 409-035-0060 Transfer of J-1 Waiver Physician Obligation

​Rule: OAR 409-001
Applicable Statute: ORS 183.341 and 413.042

ORS 409-001 contains the following rule:

  • 409-001-0005 Model Rules of Procedure


Resources

State Laws (ORS)
Secretary of State rules (OAR)
OHA Rulemaking

Contact Info

Mel White
Rules Coordinator
OHA-Health Policy & Analytics
500 Summer St. NE E-65
Salem, OR 97301
Cell: 971-240-2267

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