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HPA Statute Details

Current HPA Statutes

ArticleRendered

Administration, Director

Tuesday, April 11, 2017


ORS 442.011 to 442.025


       442.011 Health Policy and Analytics Division; appointment of director. There is created in the Oregon Health Authority the Health Policy and Analytics Division. The Director of the Health Policy and Analytics Division shall be appointed by the Director of the Oregon Health Authority. The Director shall be an individual with demonstrated proficiency in planning and managing programs with complex public policy and fiscal aspects such as those involved in the medical assistance program. [1993 c.725 §33; 1997 c.683 §16; 2001 c.69 §1; 2003 c.784 §5; 2007 c.697 §§14,15; 2009 c.595 §§747,748; 2011 c.720 §197; 2017 c.384]  
   
      442.015 Definitions. As used in ORS chapter 441 and this chapter, unless the context requires otherwise:
      (1) "Acquire" or "acquisition" means obtaining equipment, supplies, components or facilities by any means, including purchase, capital or operating lease, rental or donation, for the purpose of using such equipment, supplies, components or facilities to provide health services in Oregon. When equipment or other materials are obtained outside of this state, acquisition is considered to occur when the equipment or other materials begin to be used in Oregon for the provision of health services or when such services are offered for use in Oregon.
      (2) "Affected persons" has the same meaning as given to "party" in ORS 183.310.
      (3)(a) "Ambulatory surgical center" means a facility or portion of a facility that operates exclusively for the purpose of providing surgical services to patients who do not require hospitalization and for whom the expected duration of services does not exceed 24 hours following admission.
      (b) "Ambulatory surgical center" does not mean:
      (A) Individual or group practice offices of private physicians or dentists that do not contain a distinct area used for outpatient surgical treatment on a regular and organized basis, or that only provide surgery routinely provided in a physician's or dentist's office using local anesthesia or conscious sedation; or
      (B) A portion of a licensed hospital designated for outpatient surgical treatment.
      (4) "Delegated credentialing agreement" means a written agreement between an originating-site hospital and a distant-site hospital that provides that the medical staff of the originating-site hospital will rely upon the credentialing and privileging decisions of the distant-site hospital in making recommendations to the governing body of the originating-site hospital as to whether to credential a telemedicine provider, practicing at the distant-site hospital either as an employee or under contract, to provide telemedicine services to patients in the originating-site hospital.
      (5) "Develop" means to undertake those activities that on their completion will result in the offer of a new institutional health service or the incurring of a financial obligation, as defined under applicable state law, in relation to the offering of such a health service.
      (6) "Distant-site hospital" means the hospital where a telemedicine provider, at the time the telemedicine provider is providing telemedicine services, is practicing as an employee or under contract.
      (7) "Essential long term care facility" means an individual long term care facility that serves predominantly rural and frontier communities, as designated by the Office of Rural Health, and meets other criteria established by the Department of Human Services by rule.
      (8) "Expenditure" or "capital expenditure" means the actual expenditure, an obligation to an expenditure, lease or similar arrangement in lieu of an expenditure, and the reasonable value of a donation or grant in lieu of an expenditure but not including any interest thereon.
      (9) "Freestanding birthing center" means a facility licensed for the primary purpose of performing low risk deliveries.
      (10) "Governmental unit" means the state, or any county, municipality or other political subdivision, or any related department, division, board or other agency.
      (11) "Gross revenue" means the sum of daily hospital service charges, ambulatory service charges, ancillary service charges and other operating revenue. "Gross revenue" does not include contributions, donations, legacies or bequests made to a hospital without restriction by the donors.
      (12)(a) "Health care facility" means:
      (A) A hospital;
      (B) A long term care facility;
      (C) An ambulatory surgical center;
      (D) A freestanding birthing center; or
      (E) An outpatient renal dialysis center.
      (b) "Health care facility" does not mean:
      (A) A residential facility licensed by the Department of Human Services or the Oregon Health Authority under ORS 443.415;
      (B) An establishment furnishing primarily domiciliary care as described in ORS 443.205;
      (C) A residential facility licensed or approved under the rules of the Department of Corrections;
      (D) Facilities established by ORS 430.335 for treatment of substance abuse disorders; or
      (E) Community mental health programs or community developmental disabilities programs established under ORS 430.620.
      (13) "Health maintenance organization" or "HMO" means a public organization or a private organization organized under the laws of any state that:
      (a) Is a qualified HMO under section 1310 (d) of the U.S. Public Health Services Act; or
      (b)(A) Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services:
      (i) Usual physician services;
      (ii) Hospitalization;
      (iii) Laboratory;
      (iv) X-ray;
      (v) Emergency and preventive services; and
      (vi) Out-of-area coverage;
      (B) Is compensated, except for copayments, for the provision of the basic health care services listed in subparagraph (A) of this paragraph to enrolled participants on a predetermined periodic rate basis; and
      (C) Provides physicians' services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis.
      (14) "Health services" means clinically related diagnostic, treatment or rehabilitative services, and includes alcohol, drug or controlled substance abuse and mental health services that may be provided either directly or indirectly on an inpatient or ambulatory patient basis.
      (15) "Hospital" means:
      (a) A facility with an organized medical staff and a permanent building that is capable of providing 24-hour inpatient care to two or more individuals who have an illness or injury and that provides at least the following health services:
      (A) Medical;
      (B) Nursing;
      (C) Laboratory;
      (D) Pharmacy; and
      (E) Dietary; or
      (b) A special inpatient care facility as that term is defined by the authority by rule.
      (16) "Institutional health services" means health services provided in or through health care facilities and includes the entities in or through which such services are provided.
      (17) "Intermediate care facility" means a facility that provides, on a regular basis, health-related care and services to individuals who do not require the degree of care and treatment that a hospital or skilled nursing facility is designed to provide, but who because of their mental or physical condition require care and services above the level of room and board that can be made available to them only through institutional facilities.
      (18)(a) "Long term care facility" means a permanent facility with inpatient beds, providing:
      (A) Medical services, including nursing services but excluding surgical procedures except as may be permitted by the rules of the Director of Human Services; and
      (B) Treatment for two or more unrelated patients.
      (b) "Long term care facility" includes skilled nursing facilities and intermediate care facilities but does not include facilities licensed and operated pursuant to ORS 443.400 to 443.455.
      (19) "New hospital" means:
      (a) A facility that did not offer hospital services on a regular basis within its service area within the prior 12-month period and is initiating or proposing to initiate such services; or
      (b) Any replacement of an existing hospital that involves a substantial increase or change in the services offered.
      (20) "New skilled nursing or intermediate care service or facility" means a service or facility that did not offer long term care services on a regular basis by or through the facility within the prior 12-month period and is initiating or proposing to initiate such services. "New skilled nursing or intermediate care service or facility" also includes the rebuilding of a long term care facility, the relocation of buildings that are a part of a long term care facility, the relocation of long term care beds from one facility to another or an increase in the number of beds of more than 10 or 10 percent of the bed capacity, whichever is the lesser, within a two-year period in a facility that applied for a certificate of need between August 1, 2011, and December 1, 2012, or submitted a letter of intent under ORS 442.315 (7) between January 15, 2013, and January 31, 2013.
      (21) "Offer" means that the health care facility holds itself out as capable of providing, or as having the means for the provision of, specified health services.
      (22) "Originating-site hospital" means a hospital in which a patient is located while receiving telemedicine services.
      (23) "Outpatient renal dialysis facility" means a facility that provides renal dialysis services directly to outpatients.
      (24) "Person" means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), a state, or a political subdivision or instrumentality, including a municipal corporation, of a state.
      (25) "Skilled nursing facility" means a facility or a distinct part of a facility, that is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or an institution that provides rehabilitation services for the rehabilitation of individuals who are injured or sick or who have disabilities.
      (26) "Telemedicine" means the provision of health services to patients by physicians and health care practitioners from a distance using electronic communications. [1977 c.751 §1; 1979 c.697 §2; 1979 c.744 §31; 1981 c.693 §1; 1983 c.482 §1; 1985 c.747 §16; 1987 c.320 §233; 1987 c.660 §4; 1987 c.753 §2; 1989 c.708 §5; 1989 c.1034 §5; 1991 c.470 §9; 2001 c.100 §1; 2001 c.104 §181a; 2001 c.900 §179; 2003 c.75 §91; 2003 c.784 §11; 2005 c.22 §300; 2007 c.70 §242; 2009 c.595 §749; 2009 c.792 §63; 2013 c.414 §3; 2013 c.608 §16]
 
      Note: The amendments to 442.015 by section 22, chapter 608, Oregon Laws 2013, become operative June 30, 2020. See section 26, chapter 608, Oregon Laws 2013. The text that is operative on and after June 30, 2020, is set forth for the user's convenience.
      442.015. As used in ORS chapter 441 and this chapter, unless the context requires otherwise:
      (1) "Acquire" or "acquisition" means obtaining equipment, supplies, components or facilities by any means, including purchase, capital or operating lease, rental or donation, for the purpose of using such equipment, supplies, components or facilities to provide health services in Oregon. When equipment or other materials are obtained outside of this state, acquisition is considered to occur when the equipment or other materials begin to be used in Oregon for the provision of health services or when such services are offered for use in Oregon.
      (2) "Affected persons" has the same meaning as given to "party" in ORS 183.310.
      (3)(a) "Ambulatory surgical center" means a facility or portion of a facility that operates exclusively for the purpose of providing surgical services to patients who do not require hospitalization and for whom the expected duration of services does not exceed 24 hours following admission.
      (b) "Ambulatory surgical center" does not mean:
      (A) Individual or group practice offices of private physicians or dentists that do not contain a distinct area used for outpatient surgical treatment on a regular and organized basis, or that only provide surgery routinely provided in a physician's or dentist's office using local anesthesia or conscious sedation; or
      (B) A portion of a licensed hospital designated for outpatient surgical treatment.
      (4) "Delegated credentialing agreement" means a written agreement between an originating-site hospital and a distant-site hospital that provides that the medical staff of the originating-site hospital will rely upon the credentialing and privileging decisions of the distant-site hospital in making recommendations to the governing body of the originating-site hospital as to whether to credential a telemedicine provider, practicing at the distant-site hospital either as an employee or under contract, to provide telemedicine services to patients in the originating-site hospital.
      (5) "Develop" means to undertake those activities that on their completion will result in the offer of a new institutional health service or the incurring of a financial obligation, as defined under applicable state law, in relation to the offering of such a health service.
      (6) "Distant-site hospital" means the hospital where a telemedicine provider, at the time the telemedicine provider is providing telemedicine services, is practicing as an employee or under contract.
      (7) "Expenditure" or "capital expenditure" means the actual expenditure, an obligation to an expenditure, lease or similar arrangement in lieu of an expenditure, and the reasonable value of a donation or grant in lieu of an expenditure but not including any interest thereon.
      (8) "Freestanding birthing center" means a facility licensed for the primary purpose of performing low risk deliveries.
      (9) "Governmental unit" means the state, or any county, municipality or other political subdivision, or any related department, division, board or other agency.
      (10) "Gross revenue" means the sum of daily hospital service charges, ambulatory service charges, ancillary service charges and other operating revenue. "Gross revenue" does not include contributions, donations, legacies or bequests made to a hospital without restriction by the donors.
      (11)(a) "Health care facility" means:
      (A) A hospital;
      (B) A long term care facility;
      (C) An ambulatory surgical center;
      (D) A freestanding birthing center; or
      (E) An outpatient renal dialysis center.
      (b) "Health care facility" does not mean:
      (A) A residential facility licensed by the Department of Human Services or the Oregon Health Authority under ORS 443.415;
      (B) An establishment furnishing primarily domiciliary care as described in ORS 443.205;
      (C) A residential facility licensed or approved under the rules of the Department of Corrections;
      (D) Facilities established by ORS 430.335 for treatment of substance abuse disorders; or
      (E) Community mental health programs or community developmental disabilities programs established under ORS 430.620.
      (12) "Health maintenance organization" or "HMO" means a public organization or a private organization organized under the laws of any state that:
      (a) Is a qualified HMO under section 1310 (d) of the U.S. Public Health Services Act; or
      (b)(A) Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services:
      (i) Usual physician services;
      (ii) Hospitalization;
      (iii) Laboratory;
      (iv) X-ray;
      (v) Emergency and preventive services; and
      (vi) Out-of-area coverage;
      (B) Is compensated, except for copayments, for the provision of the basic health care services listed in subparagraph (A) of this paragraph to enrolled participants on a predetermined periodic rate basis; and
      (C) Provides physicians' services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis.
      (13) "Health services" means clinically related diagnostic, treatment or rehabilitative services, and includes alcohol, drug or controlled substance abuse and mental health services that may be provided either directly or indirectly on an inpatient or ambulatory patient basis.
      (14) "Hospital" means:
      (a) A facility with an organized medical staff and a permanent building that is capable of providing 24-hour inpatient care to two or more individuals who have an illness or injury and that provides at least the following health services:
      (A) Medical;
      (B) Nursing;
      (C) Laboratory;
      (D) Pharmacy; and
      (E) Dietary; or
      (b) A special inpatient care facility as that term is defined by the authority by rule.
      (15) "Institutional health services" means health services provided in or through health care facilities and includes the entities in or through which such services are provided.
      (16) "Intermediate care facility" means a facility that provides, on a regular basis, health-related care and services to individuals who do not require the degree of care and treatment that a hospital or skilled nursing facility is designed to provide, but who because of their mental or physical condition require care and services above the level of room and board that can be made available to them only through institutional facilities.
      (17)(a) "Long term care facility" means a permanent facility with inpatient beds, providing:
      (A) Medical services, including nursing services but excluding surgical procedures except as may be permitted by the rules of the Director of Human Services; and
      (B) Treatment for two or more unrelated patients.
      (b) "Long term care facility" includes skilled nursing facilities and intermediate care facilities but does not include facilities licensed and operated pursuant to ORS 443.400 to 443.455.
      (18) "New hospital" means:
      (a) A facility that did not offer hospital services on a regular basis within its service area within the prior 12-month period and is initiating or proposing to initiate such services; or
      (b) Any replacement of an existing hospital that involves a substantial increase or change in the services offered.
      (19) "New skilled nursing or intermediate care service or facility" means a service or facility that did not offer long term care services on a regular basis by or through the facility within the prior 12-month period and is initiating or proposing to initiate such services. "New skilled nursing or intermediate care service or facility" also includes the rebuilding of a long term care facility, the relocation of buildings that are a part of a long term care facility, the relocation of long term care beds from one facility to another or an increase in the number of beds of more than 10 or 10 percent of the bed capacity, whichever is the lesser, within a two-year period.
      (20) "Offer" means that the health care facility holds itself out as capable of providing, or as having the means for the provision of, specified health services.
      (21) "Originating-site hospital" means a hospital in which a patient is located while receiving telemedicine services.
      (22) "Outpatient renal dialysis facility" means a facility that provides renal dialysis services directly to outpatients.
      (23) "Person" means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), a state, or a political subdivision or instrumentality, including a municipal corporation, of a state.
      (24) "Skilled nursing facility" means a facility or a distinct part of a facility, that is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or an institution that provides rehabilitation services for the rehabilitation of individuals who are injured or sick or who have disabilities.
      (25) "Telemedicine" means the provision of health services to patients by physicians and health care practitioners from a distance using electronic communications.

 
      442.025 Findings and policy. (1) The Legislative Assembly finds that the achievement of reasonable access to quality health care at a reasonable cost is a priority of the State of Oregon.
      (2) Problems preventing the priority in subsection (1) of this section from being attained include:
      (a) The inability of many citizens to pay for necessary health care, being covered neither by private insurance nor by publicly funded programs such as Medicare and Medicaid;
      (b) Rising costs of medical care which exceed substantially the general rate of inflation;
      (c) Insufficient price competition in the delivery of health care services that would provide a greater cost consciousness among providers, payers and consumers;
      (d) Inadequate incentives for the use of less costly and more appropriate alternative levels of health care;
      (e) Insufficient or inappropriate use of existing capacity, duplicated services and failure to use less costly alternatives in meeting significant health needs; and
      (f) Insufficient primary and emergency medical care services in medically underserved areas of the state.
      (3) As a result of rising health care costs and the concern expressed by health care providers, health care users, third-party payers and the general public, there is an urgent need to abate these rising costs so as to place the cost of health care within reach of all Oregonians without affecting the quality of care.
      (4) To foster the cooperation of the separate industry forces, there is a need to compile and disseminate accurate and current data, including but not limited to price and utilization data, to meet the needs of the people of Oregon and improve the appropriate usage of health care services.
      (5) It is the purpose of this chapter to establish area-wide and state planning for health services, staff and facilities in light of the findings of subsection (1) of this section and in furtherance of health planning policies of this state.
      (6) It is further declared that hospital costs should be contained through improved competition between hospitals and improved competition between insurers and through financial incentives on behalf of providers, insurers and consumers to contain costs. As a safety net, it is the intent of the Legislative Assembly to monitor hospital performance. [1977 c.751 §2; 1981 c.693 §2; 1983 c.482 §2; 1985 c.747 §1; 1987 c.660 §3]
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