Laws and Rules Governing the Health Policy and Analytics Division

The laws governing the activities and scope of the Health Policy and Analytics Division (HPA) are defined in the Oregon Revised Statutes (ORS). The Oregon Administrative Rules (OAR) determine how those laws will be implemented. Learn more from the State Legislative website and the Secretary of State website.

Current Rulemakings

Proposed Permanent Rulemakings

Adopted Rules

HPA Rules by CHAPTER NUMBER

Chapter 409 - Health Policy and Analytics
Chapter 431 - Oregon Prescription Drug Program (OPDP)

HPA Rules by SUBJECT CATEGORIES

HPA rules basically fall into three categories: 1) Commissions; 2) Data Reporting, and 3) Programs. The links below provide additional information not found on the Secretary of State's website, including:

Rule (current and upcoming)
Attachments, tables, forms (if applicable)
Applicable statutes (ORS) that govern the rule
Program website

Commissions

Health Evidence Review Commission (HERC)

OAR 409-060

Rule: OAR 409-060
Applicable statutes
Commission website

OAR 409-060 includes the following rules:

409-060-0100 Scope
409-060-0110 Definitions
409-060-0120 HERC Process for Evidence-based Reports
409-060-0130 Medical Technology Assessments
409-060-0140 Evidence-based Guidelines
409-060-0150 Coverage Guidelines

Pain Management Commission (PMC)

OAR 409-050

Rule: OAR 409-050
Applicable Statutes
Commission Website

OAR 409-050 includes the following rules:

409-050-0100 Purpose
409-050-0110 Definitions
409-050-0120 Commission Positions
409-050-0130 Pain Management Education Program Requirements

Data Reporting Rules

Access of Data and Fees for Data Search

OAR 409-021

Rule: OAR 409-021
Applicable Statutes

OAR 409-021 includes the following rules:

409-021-0005 Introduction
409-021-0010 Definitions
409-021-0115 Calculations of Fees
409-021-0120 Inspection of Health Data
409-021-0130 Requests to Obtain Copies of Public Use Health Data Files
409-021-0140 Requests & Requirements to Obtain Restricted Health Data Sets
409-021-0150 Denial of Requests to Inspect or Obtain Copies of Health Data

All Payer All Claims Data Reporting Program

OAR 409-025

Effective July 1, 2019
OAR 409-025 rule, filed 5-30-2019), filed 5-30-2019)
Appendices A-G and 1 & 2, Version 2019.1.0
Data Submission Schedule, 1-31-2019 to 1-31-2022
APAC Submission Memo for Version 2019.1.0 and 2020.0.0
FAQs for Version 2019.1.0 and 2020.0.0

Effective January 1, 2020
OAR 409-025 rule, filed 5-30-19)
Appendices A-G and 1 & 2, Version 2019.1.0
Data Submission Schedule, 1-31-2019 to 1-31-2022
APAC Submission Memo for Version 2019.1.0 and 2020.0.0
FAQs for Version 2019.1.0 and 2020.0.0

Applicable Statutes

Program Website

Capital Project Reporting Program

OAR 409-024

Rule: OAR 409-024
Applicable Statutes
Program Website

OAR 409-024 includes the following rules:

409-024-0000 Definitions
409-024-0110 Capital Project Report
409-024-0120 Public Comments
409-024-0130 Civil Penalties

Community Benefit Reporting

OAR 409-023

Rule: OAR 409-023
Applicable Statutes
Program website

OAR 409-023 consists of the following rules:

409-023-0100 Definitions
409-023-0105 Community Benefit Reporting
409-023-0110 Community Benefit Minimum Spending Floor
409-023-0115 Annual reports of financial assistance policies and nonprofit status

Healthcare Workforce Database

OAR 409-026

Rule: OAR 409-026
Applicable Statute
Program Website

OAR 409-026 includes the following rules:

409-026-0100 Definitions
409-026-0110 Data Elements
409-026-0120 Reporting Schedule and Format
409-026-0130 Fees
409-026-0140 Data Access

Health Care Facility Financial Reporting

OAR 409-015

Rule: OAR 409-015
Applicable Statutes
Program website

OAR 409-015 includes the folowing rules:

409-015-0005 Definitions
409-015-0010 Report Forms
409-015-0012 Filing Date
409-015-0015 Reports Required
409-015-0030 Modification of Reporting Requirements
409-015-0035 Civil Penalties

Health Care Facility Utilization and Discharge Data Submission Requirements

OAR 409-022

Rule: OAR 409-022
Applicable Statutes: ORS 442.370

OAR 409-022 includes the following rules:

409-022-0010 Definitions
409-022-0015 Health Care Facility Annual Reports
409-022-0020 Hospital Reporting Requirements
409-022-0025 Ambulatory Surgical Centers Requirements
409-022-0035 Ambulatory Surgical Center Fees
409-022-0060 Access to Health Data
409-022-0070 Health Care Facility Utilization and Discharge Data Use and Disclosure

Primary Care Services Reporting

OAR 409-027

Rule: OAR 409-027

OAR 409-027 includes the following rules:includes the following rules:

OAR 409-027-0005 Purpose and Scope
OAR 409-027-0015 Definitions
OAR 409-027-0025 Coordinated Care Organization (CCO) Reporting Requirements

Forms:
Non-Claims Based Expenditures Reporting Template
Guidance document for Template
PC Codes for Template

Primary Care Payments

OAR 409-028

Rule: OAR 409-028
Annual Supplemental Provider Level APM Summary Report Form
Website: https://www.oregon.gov/oha/HPA/ANALYTICS/Pages/All-Payer-All-Claims.aspx

OAR 409-028 includes the following rules:includes the following rules:

409-028-0000 Purpose and Scope
409-028-0010 Definitions
409-028-0020 Coordinated Care Organization (CCO) Reporting Requirements

Programs

Health Care Practitioner Credentialing

OAR 409-045

Rule: OAR 409-045
Application Forms: Credentialing / Recredentialing
Applicable Statutes
Program Website

OAR 409-045 includes the following rules:

409-045-0025 Definitions
409-045-0030 Oregon Common Credentialing Program
409-045-0035 Oregon Practitioner Credentialing Application
409-045-0040 Credentialing Information Verifications
409-045-0045 Health Care Regulatory Board Participation
409-045-0050 Credentialing Organization Participation
409-045-0055 Health Care Practitioner Participation
409-045-0060 Use of Health Care Practitioner Information
409-045-0065 Common Credentialing Advisory Group
409-045-0070 Imposition of Fees
409-045-0075 Complaints
409-045-0115 Telemedicine Providers General Applicability Credentialing Requirements
409-045-0120 Telemedicine Providers Standard List of Credentialing Documents
409-045-0125 Telemedicine Providers Distant-Site Hospital Agreements
409-045-0130 Telemedicine Providers Hold Harmless Clause
409-045-0135 Telemedicine Providers Information Sharing or Use of Data

Healthcare Provider Incentive Program

OAR 409-036

OAR 409-036 includes the following rules:

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

Program Website
Statute

Health Profession Student Clinical Training Administrative Requirements

OAR 409-030

Rule: OAR 409-030 (rev. 11-15-19)
Attachment: Table 1
Statute
Program Website

OAR 409-030 includes the following rules:

409-030-0100 Purpose
409-030-0110 Definitions
409-030-0120 General Applicability
409-030-0130 Health Professional Disciplines
409-030-0140 Clinical Settings
409-030-0150 Exceptions
409-030-0160 Regular Review of Clinical Standards
409-030-0170 Administrative Requirements for Clinical Placement
409-030-0180 Immunization Standards
409-030-0190 Screening Standards
409-030-0200 Tuberculosis Screening
409-030-0210 Drug Testing for Substance Abuse and Misuse
409-030-0220 State and Nationwide Criminal Background Checks
409-030-0230 Training Standards
409-030-0240 Insurance and Liability Coverage
409-030-0250 Information Sharing or Use of Data

Oregon Prescription Drug Program (OPDP)

ORS 431-121

Rule: ORS 431-121
Applicable Statutes
Program website

OAR 431-121 contains the following rules:

431-121-2000 Definitions
431-121-2005 General Administration
431-121-2010 Pharmacy Providers
431-121-2020 Program Price
431-121-2030 Preferred Drug List
431-121-2050 Enrollment
431-121-2065 Contracted Services

Patient-Centered Primary Care Home Program (PCPCH)

OAR 409-055

Rule: OAR 409-055
Attachment: Tables 1-4
Applicable Statutes
Program Website

OAR 409-055 contains the following rules:

409-055-0000 Purpose & Scope
409-055-0010 Definitions
409-055-0020 Program Administration
409-055-0030 Practice Application & Recognition Process
409-055-0040 Recognition Criteria
409-055-0045 5 STAR Designation
409-055-0050 Data Reporting Requirements for Recognized PCPCHs
409-055-0060 Verification
409-055-0070 Compliance
409-055-0080 Insurance Carrier, Managed Care Plan & Public Stakeholder Communication
409-055-0090 Reimbursement Objectives

Physician Visa Waiver Program

OAR 409-035

Rule: 409-035
Applicable Statutes
Program Website

OAR 409-035 contains the following rules:

409-035-0000 Purpose
409-035-0010 Definitions
409-035-0020 Health Care Facility Participation Requirements
409-035-0030 Physician Participation Requirements
409-035-0040 Application Review Process
409-035-0050 Monitoring and Follow-up Requirements
409-035-0060 Transfer of J-1 Waiver Physician Obligation

Procedural Rules (HPA)

OAR 409-001

Rule: OAR 409-001
Applicable Statute: ORS 183.341 and 413.042

ORS 409-001 contains the following rule:

409-001-0005 Model Rules of Procedure

Resources

State Laws (ORS)
Secretary of State rules (OAR)
OHA Rulemaking

Contact Info

Pete Edlund
Rules Coordinator
OHA-Health Policy & Analytics
421 SW Oak Street, Ste. 850
Portland, OR 97204
Cell: 503-931-8873

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