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Health Policy and Analytics Administrative Rules

Temporary Rules

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    There are no temporary rules at this time.

Proposed Rule Revisions and Hearings

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The Oregon Health Authority is extending the public written comment period to October 30, 2017, at 5:00 pm relating to:

OAR 409-045 Health Care Practitioner Credentialing

Background: The public comment period for the Common Credentialing Notice of Proposed Rules originally opened on August 1, 2017. The proposed rules had a disclaimer that included two items labeled as temporary or subject to change – the treatment of “health systems” and the operational date of the program. A hearing was held on Wednesday, August 16, 2017 and written comments were received through August 18, 2017. The Authority received input from several stakeholders during the public comment period asking for further discussion on the treatment of “health systems” in particular, before final regulations are adopted by the Authority. Please see the Public Written Comment Extension memo for more detailed information and upcoming RAC meeting.

Please email or mail written comments by October 30 to:

Zarie.Haverkate@dhsoha.state.or.us.  
OHA – Health Policy & Analytics Division
Zarie Haverkate, Rules Coordinator
500 Summer Street NE, E-65
Salem, OR 97301

A Rules Advisory Committee (RAC) meeting will be held on:

Wednesday, October 25, 2017, 2:00 - 4:00 pm
Oregon Health Authority, Lincoln Building
Transformation Training Room (7th Floor) 
421 SW Oak Street, Suite 775
Portland, Oregon 97204

Conference Call Number: 1-888-808-6929; Access Code: 2474583

Agenda
Latest Rule Draft

Adopted Rules

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Chapter 409 - Health Policy and Analytics Division, Oregon Administrative Rules

Division 1  – PROCEDURAL RULES

Rule Number Section Title Effective Date
409-001-0000 Notice of Proposed Rules 01/02/2002
409-001-0005 Model Rules of Procedure 01/02/2002

Division 15   – HEALTH CARE FACILITY FINANCIAL REPORTING

Rule Number Section Title Effective Date
409-015-0005 Definitions 03/28/2016
409-015-0010 Report Forms 03/28/2016
409-015-0012 Filing Date 10/01/2010
409-015-0015 Reports Required 03/28/2016
409-015-0030 Modification of Reporting Requirements 03/28/2016
409-015-0035 Civil Penalties 03/28/2016

Division 21  – ACCESS OF DATA AND FEES FOR DATA SEARCH

Rule Number Section Title Effective Date
409-021-0005 Introduction 01/02/2002
409-021-0010 Definitions 02/01/2007
409-021-0115 Calculations of Fees 02/01/2007
409-021-0120 Inspection of Health Data 02/01/2007
409-021-0130 Requests to Obtain Copies of Public Use Health Data Files 02/01/2013
409-021-0140 Requests and Requirements to Obtain Restricted Health Data Sets 02/01/2007
403-021-0150 Denial of Requests to Inspect or Obtain Copies of Health Data 02/01/2007

Division 22  – REQUIREMENTS FOR SUBMISSION OF HEALTH CARE FACILITY UTILIZATION DATA; AMBULATORY SURGERY

Rule Number Section Title Effective Date
409-022-0005 Annual Reports 01/02/2002

Ambulatory Surgical Data Reporting Program

Rule Number Section Title Effective Date
409-022-0010 Definitions 07/01/2015
409-022-0020 Reporting Source of Ambulatory Surgical Center 07/01/2015
403-022-0060 Access to Health Data 07/01/2015
403-022-0070 Limited Data Sets with a Date Use Agreement 07/01/2015

Division 23  – HOSPITAL REPORTING
Community Benefit Reporting Program

Rule Number Section Title Effective Date
409-023-0100 Definitions 07/01/2008
409-023-0105 Reporting 07/01/2008

Division 24  - CAPITAL PROJECT REPORTING PROGRAM

Rule Number Section Title Effective Date
409-024-0000 Definitions 09/24/2015
409-024-0110 Capital Project Report 09/24/2015
409-024-0120 Public Comments 09/24/2015
409-024-0130 Civil Penalties 09/24/2015

Division 25  - ALL-PAYER ALL CLAIMS DATA REPORTING PROGRAM
(current rule through 12-31-2017)
Rule effective 1-1-2018

Rule Number Section Title Effective Date
409-025-0100 Definitions 01/01/2017
409-025-0110 General Reporting Requirements 01/01/2017
409-025-0120 Data File Layout, Format, and Coding Requirements 05/03/2017
409-025-0130 Data Submission Requirements 01/01/2017
409-025-0140 Waivers and Exceptions 01/05/2016
409-025-0150 Compliance and Enforcement 01/01/2017
409-025-0160 Data Access and Release 01/05/2016
409-025-0170 Public Disclosure 01/05/2016

Appendices A - H, Schedule A


Division 26  - OREGON HEALTHCARE WORKFORCE DATABASE

Rule Number Section Title Effective Date
409-026-0100 Definitions 03/25/2016
409-026-0110 Data Elements 03/25/2016
409-026-0120 Reporting Schedule and Format 03/25/2016
409-026-0130 Fees 03/25/2016
409-026-0140 Data Access 03/25/2016

Division 27  - PRIMARY CARE SERVICES REPORTING

Rule Number Section Title Effective Date
409-027-0005 Purpose and Scope 07/08/2016
409-026-0015 Definitions 07/08/2016
409-026-0025 Coordinated Care Organization (CCO) Reporting Requirements 07/08/2016
Non-Claims Based Expenditures Reporting Template
Guidance document for Template

Division 30  – ADMINISTRATIVE REQUIREMENTS FOR HEALTH PROFESSION STUDENT CLINICAL TRAINING

Rule Number Section Title Effective Date
409-030-0100 Purpose 07/01/2014
409-030-0110 Definitions 07/01/2015
409-030-0120 General applicability 07/01/2014
409-030-0130 Health Professional Disciplines 07/01/2014
409-030-0140 Clinical Settings 07/01/2015
403-030-0150 Exceptions 07/01/2015
403-030-0160 Regular Review of Clinical Standards 07/01/2015
403-030-0170 Administrative Requirements for Clinical Placement 07/01/2015
403-030-0180 Immunization Standards 07/01/2015
403-030-0190 Screening Standards 07/01/2015
409-030-0200 Tuberculosis Screening 07/01/2014
409-030-0210 Drug Testing for Substance Abuse and Misuse 07/01/2015
409-030-0220 State and Nationwide Criminal Background Checks 07/01/2015
409-030-0230 Training Standards 07/01/2015
409-030-0240 Insurance and Liability Coverage 07/01/2014
409-030-0250 Information Sharing or Use of Data 07/01/2014
Attachment (Table 1) 07/01/2014

Division 35  - PHYSICIAN VISA WAIVER PROGRAM

Rule Number Section Title Effective Date
409-035-0000 Purpose of the Physician Visa Waiver Program 01/01/2011
409-035-0010 Definitions 01/01/2011
409-035-0020 Health Care Facility Participation Requirements 04/22/2016
409-035-0030 Physician Participation Requirements 01/01/2011
409-035-0040 Application Review Process 02/01/2015
409-035-0050 Monitoring and Follow-up Requirements 01/01/2011
409-035-0060 Transfer of J-1 Waiver Physician Obligation 01/01/2011

Division 37  – MEDICAID PRIMARY CARE LOAN REPAYMENT PROGRAM

Rule Number Section Title Effective Date
409-037-0000 Purpose 09/04/2013
409-037-0010 Definitions 09/04/2013
409-037-0020 Participation and Application Requirements 09/04/2013
409-037-0030 Application and Review Process 09/04/2013
409-037-0040 Maximum Award Amounts 09/04/2013
403-037-0050 Transfer of Medicaid Loan Repayment Provider Service Obligation 09/04/2013
403-037-0060 Suspension or Waiver of Minimum Service Obligation 09/04/2013
403-037-0070 Failure to Comply; Penalties 09/04/2013
403-037-0080 Monitoring and Follow-up Requirements 09/04/2013

Division 45  - HEALTH CARE PRACTITIONER CREDENTIALING

Rule Number Section Title Effective Date
409-045-0025 Definitions 07/01/2014
409-045-0030 Oregon Common Credentialing Program 07/01/2014
409-045-0035 Oregon Practitioner Credentialing Program 07/01/2014
409-045-0040 Credentialing Information Verifications 07/01/2014
409-045-0045 Health Care Regulatory Board Participation 07/01/2014
409-045-0050 Credentialing Organization Participation 07/01/2014
409-045-0055 Health Care Practitioner Participation 07/01/2014
409-045-0060 Use of Health Care Practitioner Information 07/01/2014
409-045-0065 Common Credentialing Advisory Group 07/01/2014
409-045-0070 Imposition of Fees 07/01/2014
409-045-0075 Complaints 07/01/2014
Application Forms Credentialing / Recredentialing 05/01/2012

Credentialing Requirements for Telemedicine Providers

Rule Number Section Title Effective Date
409-045-0115 General Applicability 07/01/2014
409-045-0120 Standard List of Credentialing Documents 07/01/2014
409-045-0125 Distant-Site Hospital Agreements 07/01/2014
409-045-0130 Hold Harmless Clause 07/01/2014
409-045-0135 Information Sharing or Use of Data 07/01/2014

Division 50  - PAIN MANAGEMENT COMMISSION

Rule Number Section Title Effective Date
409-050-0100 Purpose 02/01/2011
409-050-0110 Definitions 12/01/2011
409-050-0120 Commission Positions 12/01/2011
409-050-0130 Pain Management Education Program Requirements 12/22/2011

Division 55  – PATIENT-CENTERED PRIMARY CARE HOME PROGRAM

Rule Number Section Title Effective Date
409-055-0000 Purpose and Scope 05/13/2016
409-055-0010 Definitions 05/13/2016
409-055-0020 Program Administration 05/13/2016
409-055-0030 Practice Application and Recognition Process 12/22/2016
409-055-0040 Recognition Criteria 12/22/2016
409-055-0045 5 STAR Designation 12/22/2016
403-055-0050 Data Reporting Requirements for Recognized PCPCHs 12/22/2016
403-055-0060 Verification 05/13/2016
403-055-0070 Compliance 05/13/2016
403-055-0080 Insurance Carrier, Managed Care Plan, and Public Stakeholder Communication 05/13/2016
403-055-0090 Reimbursement Objectives 05/13/2016
Attachment (Tables 1 - 4) 12/22/2016

Division 60– HEALTH EVIDENCE REVIEW COMMISSION (HERC)

Evidence-based Reports

Rule Number Section Title Effective Date
409-060-0100 Scope 02/01/2013
409-060-0110 Definitions 12/22/2016
409-060-0120 Health Evidence Review Commission Process for Evidence-based Reports 12/22/2016
409-060-0130 Medical Technology Assessments 02/01/2013
409-060-0140 Evidence-based Guidelines 12/22/2016
403-060-0150 Coverage Guidelines 12/12/2016

Division 62  – CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) PROGRAM

Rule Number Section Title Effective Date
409-062-0000 Purpose and Scope 09/26/2016
409-062-0010 Definitions 09/26/2016
409-062-0020 Program Administration 09/26/2016
409-062-0030 Application and Certification Process 09/26/2016
409-062-0040 Certification Criteria 09/26/2016
409-062-0050 Level of Readiness Designation 09/26/2016
409-062-0060 Variances 09/26/2016

Division 90  – OFFICE OF HEALTH POLICY ADMINISTRATION

Rule Number Section Title Effective Date
409-090-0020 Copy Charges 01/02/2002
409-090-0030 Charges for Printed Office of the Oregon Health Plan Administrator Reports 01/02/2002

Other HPA Rules

Oregon Prescription Drug Program (OPDP)

Oregon Educators Benefit Board (OEBB)

Public Employees' Benefit Board (PEBB)

HPA Statutes

Health Policy & Analytics Statutes

Contact Information

Zarie Haverkate
Administrative Rules Coordinator
OREGON HEALTH AUTHORITY
Health Policy & Analytics Division
Business Supports
500 Summer Street NE, E-65
Salem, OR 97301
Cell: 503-931-6420
Email: zarie.haverkate@state.or.us

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