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Chapter 409 - Health Policy and Analytics Administrative Rules

Statutes

Health Policy & Analytics Statutes

Temporary Rules

 
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    There are no temporary rules at this time.

Proposed Rule Revisions and Hearings

 
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OAR 409-025, All Payer All Claims Program proposed rule changes

Hearing Date:  Monday, June 19, 2017, 2:00 p.m. 
Hearing Location: 500 Summer St NE, Room 456, Salem OR 97301
Last Date for written comments: Wednesday, June 21, 2017, 5:00 p.m.

Adopted Rules

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

Division 1 – PROCEDURAL RULES

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

Ambulatory Surgical Data Reporting Program

Rule Number Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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 Division 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
 

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 ​​​​​