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Health Policy and Analytics Administrative Rules

Temporary Rules

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OAR 409-045
Health Care Practitioner Credentialing

Temporary rule effective: 1-18-2018 through 7-16-2018

Proposed Rule Revisions & Hearings

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There are no proposed rule revisions or hearings scheduled at this time.
 

Please email or mail written comments 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 

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

Rule Number Section Title Effective Date
409-025-0100 Definitions 01/01/2018
409-025-0110 General Reporting Requirements 01/01/2018
409-025-0120 Data File Layout, Format, and Coding Requirements 01/01/2018
409-025-0130 Data Submission Requirements 01/01/2018
409-025-0140 Waivers and Exceptions 01/05/2016
409-025-0150 Compliance and Enforcement 01/01/2018
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 28  - PRIMARY CARE PAYMENTS
Rule Number Section Title Effective Date
409-028-0000 Purpose and Scope 02/01/2018
409-028-0010 Definitions 02/01/2018
409-028-0020 Coordinated Care Organization (CCO) Reporting Requirements 02/01/2018
Annual Supplemental Provider Level APM Summary Report form

 

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 36  – HEALTHCARE PROVIDER INCENTIVE PROGRAM

Rule Number Section Title Effective Date
409-036-0000 Purpose and Scope 01/02/2018
409-036-0010 Definitions 01/02/2018
409-036-0020
Types of Incentives Offered Under the Program
01/02/2018
409-036-0030 Eligibility Criteria specific to Loan Repayment Subsidies 01/02/2018
409-036-0040 Eligibility Criteria specific to Scholarships for Students in Health Professional Training Programs at Other Instiutions of HIgher Learning 01/02/2018
409-036-0050 Eligibility Criteria and Program Requirements specific to Medical Malpractice Insurance Program Subsidies 01/02/2018
409-036-0060 Participation and Application Requirements 01/02/2018
409-036-0070 Application and Review Process 01/02/2018
409-036-0080 Maximum Award Amounts 01/02/2018
409-036-0090 Transfer of Provider Service Obligation to Another Site 01/02/2018
409-036-0100 Suspension or Waiver of Provider Service Obligation 01/02/2018
409-036-0110 Monitoring and Follow-up Requirements 01/02/2018
409-036-0120 Failure to Comply; Penalties & Appeals 01/02/2018
409-036-0130 Contributions to the Health Care Provider Incentive Fund 01/02/2018
409-036-0140 Program Integrity 01/02/2018
409-036-0150 Data Saring 01/02/2018

Division 45  - HEALTH CARE PRACTITIONER CREDENTIALING

Rule Number Section Title Effective Date
409-045-0025 Definitions 01/18/2018
409-045-0030 Oregon Common Credentialing Program 01/18/2018
409-045-0035 Oregon Practitioner Credentialing Program 01/01/2018
409-045-0040 Credentialing Information Verifications 01/01/2018
409-045-0045 Health Care Regulatory Board Participation 01/01/2018
409-045-0050 Credentialing Organization Participation 01/01/2018
409-045-0055 Health Care Practitioner Participation 01/01/2018
409-045-0060 Use of Health Care Practitioner Information 01/01/2018
409-045-0065 Common Credentialing Advisory Group 01/01/2018
409-045-0070 Imposition of Fees 01/01/2018
409-045-0075 Complaints 01/01/2018
Application Forms Credentialing / Recredentialing 05/01/2012

Credentialing Requirements for Telemedicine Providers

Rule Number Section Title Effective Date
409-045-0115 General Applicability 01/01/2018
409-045-0120 Standard List of Credentialing Documents 01/01/2018
409-045-0125 Distant-Site Hospital Agreements 01/01/2018
409-045-0130 Hold Harmless Clause 01/01/2018
409-045-0135 Information Sharing or Use of Data 01/01/2018

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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