Maximum Rate Waiver Application

​To complete the online Maximum Rate Waiver Application, you will be required to provide specific information.  Please note, if this information is not entered correctly, you will not be able to submit your online waiver application.

• Hospital/Facility or TSA License Information:  Waivers are requested by single facility/agency license.  You will need to provide the following;
• Facility ID, License/Registration Number, or the Provider Transaction Access Number (PTAN)  (dependent on facility or agency type/licensing agency) for the business​
• Date the facility/hospital/agency license/registration/facility ID number was issued by the licensing agency
• The licensing agency  (e.g. Safety Oversight and Quality, Health Care Regulation and Quality Improvement, or Health Licensing Office)
• The physical address of the facility or hospital (should match the license/registration/facility id information)
• If you/the applicant are with a TSA, you will need to provide your contact information as well as a facility/hospital contact.  Including name, email, physical address and phone number.  If you/the applicant are part of a facility or hospital, you will need to provide your contact information as well as the contact information for the TSA you are working with.  Including name, email, physical address and phone number.
  

• Waiver Type: Determine your Waiver request type (Emergency or Non-Emergency) by aligning with the Oregon Revised Statute (ORS) and Oregon Administrative Rule (OAR) guidance.
• An Emergency Waiver may be requested if; 
• There is an Emergency as defined in ORS 401.025
• The Governor declared a state of emergency pursuant to ORS 401.165
• The Governor declared a public health emergency pursuant to ORS 433.441
  
• A Non-Emergency Waiver may be requested if an acute incident has occurred or an imminent event is anticipated.  Once you indicate your primary reason, you will then need to select the related Non-Emergency Incident or Event from the drop down.  These options are;  ​
  
• Disease or outbreak not covered under ORS 401.025​, 401.165 or 433.441
• Environmental health issue not covered under ORS 401.025, 401.165 or 433.441
• Natural disaster not covered under ORS 401.025, 401.165 or 433.441
• Impacts to infrastructure not covered under ORS 401.025, 401.165 or 433.441
• Mass casualty not covered under ORS 401.025, 401.165​ or 433.441​
• Supply chain issue
• Other
  

• Waiver Period/Length:  Determine your desired Waiver length.  Non-Emergency Waivers have the option of 30, 60 or 90 calendar days.  Emergency Waivers are automatically assigned a 90-calendar day waiver period, as this is the only duration available for this waiver type.  The start/effective date of the waiver is the day after approval (for non-emergency waivers), or you can opt to select  a delayed start date within the application. 
  
  ​NOTE:  Emergency and non-emergency waivers have the option to apply for a renewal, which extends the existing waiver for a set period of time.
  

• ​Number of Personnel, Role and Desired Bill Rate: You will need to provide  the number of personnel per role you are applying to waive the maximum bill rate for, and your desired bill rate for each role.
• Visit the HB2665 FAQ for a summary of personnel subject to maximum rates or refer directly to the Oregon Administrative Rules (OAR)
• Ensure you are determining your desired bill rate, not wage rate.  Refer to the rate information to understand how bill rate is calculated, including the limit on the TSA margin within that bill rate.  A TSA may not exceed the 34.2% margin cap and may not retain funds greater than 34.2% of the bill rate.
  

• Prepare your Justification Narrative: You will need to provide justification and information that will assist OHA in determining the accuracy of your request; please be aware the word limit is 300. Non-Emergency Waiver application justifications, should include information to demonstrate the requirements as outlined in OAR 409-039-00​50 (2).​​​