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Health Policy & Analytics Statutes

Current HPA Statutes

ORS 192.311-192.324, 192.345, 192.360-192.365, 192.398,
192.411-192.431, and 442.420(3)(d)


      192.311 Definitions for ORS 192.311 to 192.478. As used in ORS 192.311 to 192.478:
      (1) “Business day” means a day other than Saturday, Sunday or a legal holiday and on which at least one paid employee of the public body that received the public records request is scheduled to and does report to work. In the case of a community college district, community college service district, public university, school district or education service district, “business day” does not include any day on which the central administration offices of the district or university are closed.
      (2) “Custodian” means:
      (a) The person described in ORS 7.110 for purposes of court records; or
      (b) A public body mandated, directly or indirectly, to create, maintain, care for or control a public record. “Custodian” does not include a public body that has custody of a public record as an agent of another public body that is the custodian unless the public record is not otherwise available.
      (3) “Person” includes any natural person, corporation, partnership, firm, association or member or committee of the Legislative Assembly.
      (4) “Public body” includes every state officer, agency, department, division, bureau, board and commission; every county and city governing body, school district, special district, municipal corporation, and any board, department, commission, council, or agency thereof; and any other public agency of this state.
      (5)(a) “Public record” includes any writing that contains information relating to the conduct of the public’s business, including but not limited to court records, mortgages, and deed records, prepared, owned, used or retained by a public body regardless of physical form or characteristics.
      (b) “Public record” does not include any writing that does not relate to the conduct of the public’s business and that is contained on a privately-owned computer.
      (6) “State agency” means any state officer, department, board, commission or court created by the Constitution or statutes of this state but does not include the Legislative Assembly or its members, committees, officers or employees insofar as they are exempt under section 9, Article IV of the Oregon Constitution.
      (7) “Writing” means handwriting, typewriting, printing, photographing and every means of recording, including letters, words, pictures, sounds, or symbols, or combination thereof, and all papers, maps, files, facsimiles or electronic recordings. [Formerly 192.410]
 
(Public Records Request Processing)
 
      192.314 Right to inspect public records; notice to public body attorney. (1) Every person has a right to inspect any public record of a public body in this state, except as otherwise expressly provided by ORS 192.338, 192.345 and 192.355.
      (2)(a) If a person who is a party to a civil judicial proceeding to which a public body is a party, or who has filed a notice under ORS 30.275 (5)(a), asks to inspect or to receive a copy of a public record that the person knows relates to the proceeding or notice, the person must submit the request in writing to the custodian and, at the same time, to the attorney for the public body.
      (b) For purposes of this subsection:
      (A) The attorney for a state agency is the Attorney General in Salem.
      (B) “Person” includes a representative or agent of the person. [Formerly 192.420]
 
      192.318 Functions of custodian of public records; rules. (1) The custodian of any public records, including public records maintained in machine readable or electronic form, unless otherwise expressly provided by statute, shall furnish proper and reasonable opportunities for inspection and examination of the records in the office of the custodian and reasonable facilities for making memoranda or abstracts therefrom, during the usual business hours, to all persons having occasion to make examination of them. If the public record is maintained in machine readable or electronic form, the custodian shall furnish proper and reasonable opportunity to assure access.
      (2) The custodian of the records may adopt reasonable rules necessary for the protection of the records and to prevent interference with the regular discharge of duties of the custodian. [Formerly 192.430]
 
      192.324 Copies or inspection of public records; public body response; fees; procedure for records requests. (1) A public body that is the custodian of any public record that a person has a right to inspect shall give the person, upon receipt of a written request:
      (a) A copy of the public record if the public record is of a nature permitting copying; or
      (b) A reasonable opportunity to inspect or copy the public record.
      (2) If an individual who is identified in a public body’s procedure described in subsection (7)(a) of this section receives a written request to inspect or receive a copy of a public record, the public body shall within five business days after receiving the request acknowledge receipt of the request or complete the public body’s response to the request. An acknowledgment under this subsection must:
      (a) Confirm that the public body is the custodian of the requested record;
      (b) Inform the requester that the public body is not the custodian of the requested record; or
      (c) Notify the requester that the public body is uncertain whether the public body is the custodian of the requested record.
      (3) If the public record is maintained in a machine readable or electronic form, the public body shall provide a copy of the public record in the form requested, if available. If the public record is not available in the form requested, the public body shall make the public record available in the form in which the public body maintains the public record.
      (4)(a) The public body may establish fees reasonably calculated to reimburse the public body for the public body’s actual cost of making public records available, including costs for summarizing, compiling or tailoring the public records, either in organization or media, to meet the request.
      (b) The public body may include in a fee established under paragraph (a) of this subsection the cost of time spent by an attorney for the public body in reviewing the public records, redacting material from the public records or segregating the public records into exempt and nonexempt records. The public body may not include in a fee established under paragraph (a) of this subsection the cost of time spent by an attorney for the public body in determining the application of the provisions of ORS 192.311 to 192.478.
      (c) The public body may not establish a fee greater than $25 under this section unless the public body first provides the requester with a written notification of the estimated amount of the fee and the requester confirms that the requester wants the public body to proceed with making the public record available.
      (d) Notwithstanding paragraphs (a) to (c) of this subsection, when the public records are those filed with the Secretary of State under ORS chapter 79 or ORS 80.100 to 80.130, the fees for furnishing copies, summaries or compilations of the public records are the fees established by the Secretary of State by rule under ORS chapter 79 or ORS 80.100 to 80.130.
      (5) The custodian of a public record may furnish copies without charge or at a substantially reduced fee if the custodian determines that the waiver or reduction of fees is in the public interest because making the record available primarily benefits the general public.
      (6) A requester who believes that there has been an unreasonable denial of a fee waiver or fee reduction may petition the Attorney General or the district attorney in the same manner as a requester who petitions when inspection of a public record is denied under ORS 192.311 to 192.478. The Attorney General, the district attorney and the court have the same authority in instances when a fee waiver or reduction is denied as when inspection of a public record is denied.
      (7) A public body shall make available to the public a written procedure for making public records requests that includes:
      (a) The name of one or more individuals within the public body to whom public records requests may be sent, with addresses; and
      (b) The amounts of and the manner of calculating fees that the public body charges for responding to requests for public records.
      (8) This section does not apply to signatures of individuals submitted under ORS chapter 247 for purposes of registering to vote as provided in ORS 247.973. [Formerly 192.440]
 
      192.345 Public records conditionally exempt from disclosure. The following public records are exempt from disclosure under ORS 192.311 to 192.478 unless the public interest requires disclosure in the particular instance:
      (1) Records of a public body pertaining to litigation to which the public body is a party if the complaint has been filed, or if the complaint has not been filed, if the public body shows that such litigation is reasonably likely to occur. This exemption does not apply to litigation which has been concluded, and nothing in this subsection shall limit any right or opportunity granted by discovery or deposition statutes to a party to litigation or potential litigation.
      (2) Trade secrets. “Trade secrets,” as used in this section, may include, but are not limited to, any formula, plan, pattern, process, tool, mechanism, compound, procedure, production data, or compilation of information which is not patented, which is known only to certain individuals within an organization and which is used in a business it conducts, having actual or potential commercial value, and which gives its user an opportunity to obtain a business advantage over competitors who do not know or use it.
      (3) Investigatory information compiled for criminal law purposes. The record of an arrest or the report of a crime shall be disclosed unless and only for so long as there is a clear need to delay disclosure in the course of a specific investigation, including the need to protect the complaining party or the victim. Nothing in this subsection shall limit any right constitutionally guaranteed, or granted by statute, to disclosure or discovery in criminal cases. For purposes of this subsection, the record of an arrest or the report of a crime includes, but is not limited to:
      (a) The arrested person’s name, age, residence, employment, marital status and similar biographical information;
      (b) The offense with which the arrested person is charged;
      (c) The conditions of release pursuant to ORS 135.230 to 135.290;
      (d) The identity of and biographical information concerning both complaining party and victim;
      (e) The identity of the investigating and arresting agency and the length of the investigation;
      (f) The circumstances of arrest, including time, place, resistance, pursuit and weapons used; and
      (g) Such information as may be necessary to enlist public assistance in apprehending fugitives from justice.
      (4) Test questions, scoring keys, and other data used to administer a licensing examination, employment, academic or other examination or testing procedure before the examination is given and if the examination is to be used again. Records establishing procedures for and instructing persons administering, grading or evaluating an examination or testing procedure are included in this exemption, to the extent that disclosure would create a risk that the result might be affected.
      (5) Information consisting of production records, sale or purchase records or catch records, or similar business records of a private concern or enterprise, required by law to be submitted to or inspected by a governmental body to allow it to determine fees or assessments payable or to establish production quotas, and the amounts of such fees or assessments payable or paid, to the extent that such information is in a form that would permit identification of the individual concern or enterprise. This exemption does not include records submitted by long term care facilities as defined in ORS 442.015 to the state for purposes of reimbursement of expenses or determining fees for patient care. Nothing in this subsection shall limit the use that can be made of such information for regulatory purposes or its admissibility in any enforcement proceeding.
      (6) Information relating to the appraisal of real estate prior to its acquisition.
      (7) The names and signatures of employees who sign authorization cards or petitions for the purpose of requesting representation or decertification elections.
      (8) Investigatory information relating to any complaint filed under ORS 659A.820 or 659A.825, until such time as the complaint is resolved under ORS 659A.835, or a final order is issued under ORS 659A.850.
      (9) Investigatory information relating to any complaint or charge filed under ORS 243.676 and 663.180.
      (10) Records, reports and other information received or compiled by the Director of the Department of Consumer and Business Services under ORS 697.732.
      (11) Information concerning the location of archaeological sites or objects as those terms are defined in ORS 358.905, except if the governing body of an Indian tribe requests the information and the need for the information is related to that Indian tribe’s cultural or religious activities. This exemption does not include information relating to a site that is all or part of an existing, commonly known and publicized tourist facility or attraction.
      (12) A personnel discipline action, or materials or documents supporting that action.
      (13) Information developed pursuant to ORS 496.004, 496.172 and 498.026 or ORS 496.192 and 564.100, regarding the habitat, location or population of any threatened species or endangered species.
      (14) Writings prepared by or under the direction of faculty of public educational institutions, in connection with research, until publicly released, copyrighted or patented.
      (15) Computer programs developed or purchased by or for any public body for its own use. As used in this subsection, “computer program” means a series of instructions or statements which permit the functioning of a computer system in a manner designed to provide storage, retrieval and manipulation of data from such computer system, and any associated documentation and source material that explain how to operate the computer program. “Computer program” does not include:
      (a) The original data, including but not limited to numbers, text, voice, graphics and images;
      (b) Analyses, compilations and other manipulated forms of the original data produced by use of the program; or
      (c) The mathematical and statistical formulas which would be used if the manipulated forms of the original data were to be produced manually.
      (16) Data and information provided by participants to mediation under ORS 36.256.
      (17) Investigatory information relating to any complaint or charge filed under ORS chapter 654, until a final administrative determination is made or, if a citation is issued, until an employer receives notice of any citation.
      (18) Specific operational plans in connection with an anticipated threat to individual or public safety for deployment and use of personnel and equipment, prepared or used by a public body, if public disclosure of the plans would endanger an individual’s life or physical safety or jeopardize a law enforcement activity.
      (19)(a) Audits or audit reports required of a telecommunications carrier. As used in this paragraph, “audit or audit report” means any external or internal audit or audit report pertaining to a telecommunications carrier, as defined in ORS 133.721, or pertaining to a corporation having an affiliated interest, as defined in ORS 759.390, with a telecommunications carrier that is intended to make the operations of the entity more efficient, accurate or compliant with applicable rules, procedures or standards, that may include self-criticism and that has been filed by the telecommunications carrier or affiliate under compulsion of state law. “Audit or audit report” does not mean an audit of a cost study that would be discoverable in a contested case proceeding and that is not subject to a protective order; and
      (b) Financial statements. As used in this paragraph, “financial statement” means a financial statement of a nonregulated corporation having an affiliated interest, as defined in ORS 759.390, with a telecommunications carrier, as defined in ORS 133.721.
      (20) The residence address of an elector if authorized under ORS 247.965 and subject to ORS 247.967.
      (21) The following records, communications and information submitted to a housing authority as defined in ORS 456.005, or to an urban renewal agency as defined in ORS 457.010, by applicants for and recipients of loans, grants and tax credits:
      (a) Personal and corporate financial statements and information, including tax returns;
      (b) Credit reports;
      (c) Project appraisals, excluding appraisals obtained in the course of transactions involving an interest in real estate that is acquired, leased, rented, exchanged, transferred or otherwise disposed of as part of the project, but only after the transactions have closed and are concluded;
      (d) Market studies and analyses;
      (e) Articles of incorporation, partnership agreements and operating agreements;
      (f) Commitment letters;
      (g) Project pro forma statements;
      (h) Project cost certifications and cost data;
      (i) Audits;
      (j) Project tenant correspondence requested to be confidential;
      (k) Tenant files relating to certification; and
      (L) Housing assistance payment requests.
      (22) Records or information that, if disclosed, would allow a person to:
      (a) Gain unauthorized access to buildings or other property;
      (b) Identify those areas of structural or operational vulnerability that would permit unlawful disruption to, or interference with, services; or
      (c) Disrupt, interfere with or gain unauthorized access to public funds or to information processing, communication or telecommunication systems, including the information contained in the systems, that are used or operated by a public body.
      (23) Records or information that would reveal or otherwise identify security measures, or weaknesses or potential weaknesses in security measures, taken or recommended to be taken to protect:
      (a) An individual;
      (b) Buildings or other property;
      (c) Information processing, communication or telecommunication systems, including the information contained in the systems; or
      (d) Those operations of the Oregon State Lottery the security of which are subject to study and evaluation under ORS 461.180 (6).
      (24) Personal information held by or under the direction of officials of the Oregon Health and Science University or a public university listed in ORS 352.002 about a person who has or who is interested in donating money or property to the Oregon Health and Science University or a public university, if the information is related to the family of the person, personal assets of the person or is incidental information not related to the donation.
      (25) The home address, professional address and telephone number of a person who has or who is interested in donating money or property to a public university listed in ORS 352.002.
      (26) Records of the name and address of a person who files a report with or pays an assessment to a commodity commission established under ORS 576.051 to 576.455, the Oregon Beef Council created under ORS 577.210 or the Oregon Wheat Commission created under ORS 578.030.
      (27) Information provided to, obtained by or used by a public body to authorize, originate, receive or authenticate a transfer of funds, including but not limited to a credit card number, payment card expiration date, password, financial institution account number and financial institution routing number.
      (28) Social Security numbers as provided in ORS 107.840.
      (29) The electronic mail address of a student who attends a public university listed in ORS 352.002 or Oregon Health and Science University.
      (30) The name, home address, professional address or location of a person that is engaged in, or that provides goods or services for, medical research at Oregon Health and Science University that is conducted using animals other than rodents. This subsection does not apply to Oregon Health and Science University press releases, websites or other publications circulated to the general public.
      (31) If requested by a public safety officer, as defined in ORS 181A.355:
      (a) The home address and home telephone number of the public safety officer contained in the voter registration records for the officer.
      (b) The home address and home telephone number of the public safety officer contained in records of the Department of Public Safety Standards and Training.
      (c) The name of the public safety officer contained in county real property assessment or taxation records. This exemption:
      (A) Applies only to the name of the public safety officer and any other owner of the property in connection with a specific property identified by the officer in a request for exemption from disclosure;
      (B) Applies only to records that may be made immediately available to the public upon request in person, by telephone or using the Internet;
      (C) Applies until the public safety officer requests termination of the exemption;
      (D) Does not apply to disclosure of records among public bodies as defined in ORS 174.109 for governmental purposes; and
      (E) May not result in liability for the county if the name of the public safety officer is disclosed after a request for exemption from disclosure is made under this subsection.
      (32) Unless the public records request is made by a financial institution, as defined in ORS 706.008, consumer finance company licensed under ORS chapter 725, mortgage banker or mortgage broker licensed under ORS 86A.095 to 86A.198, or title company for business purposes, records described in paragraph (a) of this subsection, if the exemption from disclosure of the records is sought by an individual described in paragraph (b) of this subsection using the procedure described in paragraph (c) of this subsection:
      (a) The home address, home or cellular telephone number or personal electronic mail address contained in the records of any public body that has received the request that is set forth in:
      (A) A warranty deed, deed of trust, mortgage, lien, deed of reconveyance, release, satisfaction, substitution of trustee, easement, dog license, marriage license or military discharge record that is in the possession of the county clerk; or
      (B) Any public record of a public body other than the county clerk.
      (b) The individual claiming the exemption from disclosure must be a district attorney, a deputy district attorney, the Attorney General or an assistant attorney general, the United States Attorney for the District of Oregon or an assistant United States attorney for the District of Oregon, a city attorney who engages in the prosecution of criminal matters or a deputy city attorney who engages in the prosecution of criminal matters.
      (c) The individual claiming the exemption from disclosure must do so by filing the claim in writing with the public body for which the exemption from disclosure is being claimed on a form prescribed by the public body. Unless the claim is filed with the county clerk, the claim form shall list the public records in the possession of the public body to which the exemption applies. The exemption applies until the individual claiming the exemption requests termination of the exemption or ceases to qualify for the exemption.
      (33) The following voluntary conservation agreements and reports:
      (a) Land management plans required for voluntary stewardship agreements entered into under ORS 541.973; and
      (b) Written agreements relating to the conservation of greater sage grouse entered into voluntarily by owners or occupiers of land with a soil and water conservation district under ORS 568.550.
      (34) Sensitive business records or financial or commercial information of the State Accident Insurance Fund Corporation that is not customarily provided to business competitors. This exemption does not:
      (a) Apply to the formulas for determining dividends to be paid to employers insured by the State Accident Insurance Fund Corporation;
      (b) Apply to contracts for advertising, public relations or lobbying services or to documents related to the formation of such contracts;
      (c) Apply to group insurance contracts or to documents relating to the formation of such contracts, except that employer account records shall remain exempt from disclosure as provided in ORS 192.355 (35); or
      (d) Provide the basis for opposing the discovery of documents in litigation pursuant to the applicable rules of civil procedure.
      (35) Records of the Department of Public Safety Standards and Training relating to investigations conducted under ORS 181A.640 or 181A.870 (6), until the department issues the report described in ORS 181A.640 or 181A.870.
      (36) A medical examiner’s report, autopsy report or laboratory test report ordered by a medical examiner under ORS 146.117.
      (37) Any document or other information related to an audit of a public body, as defined in ORS 174.109, that is in the custody of an auditor or audit organization operating under nationally recognized government auditing standards, until the auditor or audit organization issues a final audit report in accordance with those standards or the audit is abandoned. This exemption does not prohibit disclosure of a draft audit report that is provided to the audited entity for the entity’s response to the audit findings.
      (38)(a) Personally identifiable information collected as part of an electronic fare collection system of a mass transit system.
      (b) The exemption from disclosure in paragraph (a) of this subsection does not apply to public records that have attributes of anonymity that are sufficient, or that are aggregated into groupings that are broad enough, to ensure that persons cannot be identified by disclosure of the public records.
      (c) As used in this subsection:
      (A) “Electronic fare collection system” means the software and hardware used for, associated with or relating to the collection of transit fares for a mass transit system, including but not limited to computers, radio communication systems, personal mobile devices, wearable technology, fare instruments, information technology, data storage or collection equipment, or other equipment or improvements.
      (B) “Mass transit system” has the meaning given that term in ORS 267.010.
      (C) “Personally identifiable information” means all information relating to a person that acquires or uses a transit pass or other fare payment medium in connection with an electronic fare collection system, including but not limited to:
      (i) Customer account information, date of birth, telephone number, physical address, electronic mail address, credit or debit card information, bank account information, Social Security or taxpayer identification number or other identification number, transit pass or fare payment medium balances or history, or similar personal information; or
      (ii) Travel dates, travel times, frequency of use, travel locations, service types or vehicle use, or similar travel information.
      (39)(a) If requested by a civil code enforcement officer:
      (A) The home address and home telephone number of the civil code enforcement officer contained in the voter registration records for the officer.
      (B) The name of the civil code enforcement officer contained in county real property assessment or taxation records. This exemption:
      (i) Applies only to the name of the civil code enforcement officer and any other owner of the property in connection with a specific property identified by the officer in a request for exemption from disclosure;
      (ii) Applies only to records that may be made immediately available to the public upon request in person, by telephone or using the Internet;
      (iii) Applies until the civil code enforcement officer requests termination of the exemption;
      (iv) Does not apply to disclosure of records among public bodies as defined in ORS 174.109 for governmental purposes; and
      (v) May not result in liability for the county if the name of the civil code enforcement officer is disclosed after a request for exemption from disclosure is made under this subsection.
      (b) As used in this subsection, “civil code enforcement officer” means an employee of a public body, as defined in ORS 174.109, who is charged with enforcing laws or ordinances relating to land use, zoning, use of rights-of-way, solid waste, hazardous waste, sewage treatment and disposal or the state building code.
      (40) Audio or video recordings, whether digital or analog, resulting from a law enforcement officer’s operation of a video camera worn upon the officer’s person that records the officer’s interactions with members of the public while the officer is on duty. When a recording described in this subsection is subject to disclosure, the following apply:
      (a) Recordings that have been sealed in a court’s record of a court proceeding or otherwise ordered by a court not to be disclosed may not be disclosed.
      (b) A request for disclosure under this subsection must identify the approximate date and time of an incident for which the recordings are requested and be reasonably tailored to include only that material for which a public interest requires disclosure.
      (c) A video recording disclosed under this subsection must, prior to disclosure, be edited in a manner as to render the faces of all persons within the recording unidentifiable. [Formerly 192.501]
 
      Note: See note under 192.338.
 
     192.360 Condensation of public record subject to disclosure; petition to review denial of right to inspect public record; adequacy of condensation. (1) When a public record is subject to disclosure under ORS 192.355 (9)(b), in lieu of making the public record available for inspection by providing a copy of the record, the public body may prepare and release a condensation from the record of the significant facts that are not otherwise exempt from disclosure under ORS 192.311 to 192.478. The release of the condensation does not waive any privilege under ORS 40.225 to 40.295.
      (2) The person seeking to inspect or receive a copy of any public record for which a condensation of facts has been provided under this section may petition for review of the denial to inspect or receive a copy of the records under ORS 192.311 to 192.478. In such a review, the Attorney General, district attorney or court shall, in addition to reviewing the records to which access was denied, compare those records to the condensation to determine whether the condensation adequately describes the significant facts contained in the records. [Formerly 192.423]
 
      Note: 192.360 was added to and made a part of 192.311 to 192.478 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 
(Records Containing Personal Information)
 
      192.363 Contents of certain requests for disclosure. (1) A request for the disclosure of records described in ORS 192.355 (3) or 192.365 must include the following information:
      (a) The names of the individuals for whom personal information is sought;
      (b) A statement describing the personal information being sought; and
      (c) A statement that satisfies subsection (2) of this section.
      (2) The party seeking disclosure shall show by clear and convincing evidence that the public interest requires disclosure in a particular instance.
      (3) Upon receiving a request described in subsection (1) of this section, a public body shall forward a copy of the request and any materials submitted with the request to the individuals whose personal information is being sought or to any representatives of each class of persons whose personal information is the subject of the request.
      (4) For purposes of subsection (3) of this section, the public body has sole discretion to determine the classes of persons whose personal information is the subject of the request and to identify the representatives for each class.
      (5) The public body may not disclose information pursuant to the request for at least seven days after forwarding copies of the request under subsection (3) of this section.
      (6) The public body shall consider all information submitted under this section and shall disclose requested information only if the public body determines that the party seeking disclosure has demonstrated by clear and convincing evidence that the public interest requires disclosure in a particular instance. [Formerly 192.437]
 
      Note: 192.363 was added to and made a part of 192.311 to 192.478 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 
      192.365 Disclosure of information pertaining to home care worker, operator of child care facility, exempt child care provider or operator of adult foster home. (1) Upon compliance with ORS 192.363, a public body that is the custodian of or is otherwise in possession of the following information pertaining to a home care worker as defined in ORS 410.600, an operator of a child care facility as defined in ORS 329A.250, an exempt family child care provider as defined in ORS 329A.430 or an operator of an adult foster home as defined in ORS 443.705 shall disclose that information in response to a request to inspect public records under ORS 192.311 to 192.478:
      (a) Residential address and telephone numbers;
      (b) Personal electronic mail addresses and personal cellular telephone numbers;
      (c) Social Security numbers and employer-issued identification card numbers; and
      (d) Emergency contact information.
      (2) Subsection (1) of this section does not apply to the Judicial Department or the Department of Transportation or to any records in the custody of the Judicial Department or the Department of Transportation. [Formerly 192.435]
 
      Note: 192.365 was added to and made a part of 192.311 to 192.478 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 
      192.398 Medical records; sealed records; records of individual in custody or under supervision; student records. The following public records are exempt from disclosure:
      (1) Records less than 75 years old which contain information about the physical or mental health or psychiatric care or treatment of a living individual, if the public disclosure thereof would constitute an unreasonable invasion of privacy. The party seeking disclosure shall have the burden of showing by clear and convincing evidence that the public interest requires disclosure in the particular instance and that public disclosure would not constitute an unreasonable invasion of privacy.
      (2) Records less than 75 years old which were sealed in compliance with statute or by court order. Such records may be disclosed upon order of a court of competent jurisdiction or as otherwise provided by law.
      (3) Records of a person who is or has been in the custody or under the lawful supervision of a state agency, a court or a unit of local government, are exempt from disclosure for a period of 25 years after termination of such custody or supervision to the extent that disclosure thereof would interfere with the rehabilitation of the person if the public interest in confidentiality clearly outweighs the public interest in disclosure. Nothing in this subsection, however, shall be construed as prohibiting disclosure of the fact that a person is in custody.
      (4) Student records required by state or federal law to be exempt from disclosure. [Formerly 192.496]
 
      Note: 192.398 was added to and made a part of 192.311 to 192.478 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 
     192.411 Petition to review denial of right to inspect state public record; appeal from decision of Attorney General denying inspection. (1) Subject to ORS 192.401 (1) and 192.427, any person denied the right to inspect or to receive a copy of any public record of a state agency may petition the Attorney General to review the public record to determine if it may be withheld from public inspection. Except as provided in ORS 192.401 (2), the burden is on the agency to sustain its action. Except as provided in ORS 192.401 (2), the Attorney General shall issue an order denying or granting the petition or denying it in part and granting it in part, within seven days from the day the Attorney General receives the petition.
      (2) If the Attorney General grants the petition and orders the state agency to disclose the public record, or if the Attorney General grants the petition in part and orders the state agency to disclose a portion of the public record, the state agency shall comply with the order in full within seven days after issuance of the order, unless within the seven-day period it issues a notice of its intention to institute proceedings for injunctive or declaratory relief in the Circuit Court for Marion County or, as provided in ORS 192.401 (3), in the circuit court of the county where the public record is held. Copies of the notice shall be sent to the Attorney General and by certified mail to the petitioner at the address shown on the petition. The state agency shall institute the proceedings within seven days after it issues its notice of intention to do so. If the Attorney General denies the petition in whole or in part, or if the state agency continues to withhold the public record or a part of it notwithstanding an order to disclose by the Attorney General, the person seeking disclosure may institute such proceedings.
      (3) The Attorney General shall serve as counsel for the state agency in a suit filed under subsection (2) of this section if the suit arises out of a determination by the Attorney General that the public record should not be disclosed, or that a part of the public record should not be disclosed if the state agency has fully complied with the order of the Attorney General requiring disclosure of another part or parts of the public record, and in no other case. In any case in which the Attorney General is prohibited from serving as counsel for the state agency, the agency may retain special counsel. [Formerly subsections (1) to (3) of 192.450]
 
      192.415 Procedure to review denial of right to inspect other public records; effect of disclosure. (1) ORS 192.401 and 192.411 apply to the case of a person denied the right to inspect or to receive a copy of any public record of a public body other than a state agency, except that:
      (a) The district attorney of the county in which the public body is located, or if it is located in more than one county the district attorney of the county in which the administrative offices of the public body are located, shall carry out the functions of the Attorney General;
      (b) Any suit filed must be filed in the circuit court for the county described in paragraph (a) of this subsection; and
      (c) The district attorney may not serve as counsel for the public body, in the cases permitted under ORS 192.411 (3), unless the district attorney ordinarily serves as counsel for the public body.
      (2) Disclosure of a record to the district attorney in compliance with subsection (1) of this section does not waive any privilege or claim of privilege regarding the record or its contents.
      (3) Disclosure of a record or part of a record as ordered by the district attorney is a compelled disclosure for purposes of ORS 40.285. [Formerly 192.460]
 
      192.418 Effect of failure of Attorney General, district attorney or elected official to take timely action on inspection petition. (1) The failure of the Attorney General or district attorney to issue an order under ORS 192.401, 192.411 or 192.415 denying, granting, or denying in part and granting in part a petition to require disclosure within seven days from the day of receipt of the petition shall be treated as an order denying the petition for the purpose of determining whether a person may institute proceedings for injunctive or declaratory relief under ORS 192.401, 192.411 or 192.415.
      (2) The failure of an elected official to deny, grant, or deny in part and grant in part a request to inspect or receive a copy of a public record within seven days from the day of receipt of the request shall be treated as a denial of the request for the purpose of determining whether a person may institute proceedings for injunctive or declaratory relief under ORS 192.401, 192.411 or 192.415. [Formerly 192.465]
 
      192.420 [1973 c.794 §3; 1999 c.574 §1; 2003 c.403 §1; renumbered 192.314 in 2017]
 
      192.422 Petition form; procedure when petition received. (1) A petition to the Attorney General or district attorney requesting the Attorney General or district attorney to order a public record to be made available for inspection or to be produced shall be in substantially the following form, or in a form containing the same information:
______________________________________________________________________________
 
 
______
 (Date)
      I (we), ____________(name(s)), the undersigned, request the Attorney General (or District Attorney of ______ County) to order ______ (name of governmental body) and its employees to (make available for inspection) (produce a copy or copies of) the following records:
 
      1.____________________
(Name or description of record)
 
      2.____________________
(Name or description of record)
 
      I (we) asked to inspect and/or copy these records on ______ (date) at ______ (address). The request was denied by the following person(s):
 
      1.____________________
(Name of public officer or employee;
title or position, if known)
 
      2.____________________
(Name of public officer or employee;
title or position, if known)
 
 
______________________
 (Signature(s))
______________________________________________________________________________
 
This form should be delivered or mailed to the Attorney General’s office in Salem, or the district attorney’s office in the county courthouse.
      (2) Promptly upon receipt of such a petition, the Attorney General or district attorney shall notify the public body involved. The public body shall thereupon transmit the public record disclosure of which is sought, or a copy, to the Attorney General, together with a statement of its reasons for believing that the public record should not be disclosed. In an appropriate case, with the consent of the Attorney General, the public body may instead disclose the nature or substance of the public record to the Attorney General. [Formerly 192.470]
 
      192.423 [2007 c.513 §2; renumbered 192.360 in 2017]
 
      192.427 Procedure to review denial by elected official of right to inspect public records. In any case in which a person is denied the right to inspect or to receive a copy of a public record in the custody of an elected official, or in the custody of any other person but as to which an elected official claims the right to withhold disclosure, no petition to require disclosure may be filed with the Attorney General or district attorney, or if a petition is filed it shall not be considered by the Attorney General or district attorney after a claim of right to withhold disclosure by an elected official. In such case a person denied the right to inspect or to receive a copy of a public record may institute proceedings for injunctive or declaratory relief in the appropriate circuit court, as specified in ORS 192.401, 192.411 or 192.415, and the Attorney General or district attorney may upon request serve or decline to serve, in the discretion of the Attorney General or district attorney, as counsel in such suit for an elected official for which the Attorney General or district attorney ordinarily serves as counsel. Nothing in this section shall preclude an elected official from requesting advice from the Attorney General or a district attorney as to whether a public record should be disclosed. [Formerly 192.480]
 
      192.430 [1973 c.794 §4; 1989 c.546 §1; renumbered 192.318 in 2017]
 
      192.431 Court authority in reviewing action denying right to inspect public records; docketing; costs and attorney fees. (1) In any suit filed under ORS 192.401, 192.411, 192.415, 192.422 or 192.427, the court has jurisdiction to enjoin the public body from withholding records and to order the production of any records improperly withheld from the person seeking disclosure. The court shall determine the matter de novo and the burden is on the public body to sustain its action. The court, on its own motion, may view the documents in controversy in camera before reaching a decision. Any noncompliance with the order of the court may be punished as contempt of court.
      (2) Except as to causes the court considers of greater importance, proceedings arising under ORS 192.401, 192.411, 192.415, 192.422 or 192.427 take precedence on the docket over all other causes and shall be assigned for hearing and trial at the earliest practicable date and expedited in every way.
      (3) If a person seeking the right to inspect or to receive a copy of a public record prevails in the suit, the person shall be awarded costs and disbursements and reasonable attorney fees at trial and on appeal. If the person prevails in part, the court may in its discretion award the person costs and disbursements and reasonable attorney fees at trial and on appeal, or an appropriate portion thereof. If the state agency failed to comply with the Attorney General’s order in full and did not issue a notice of intention to institute proceedings pursuant to ORS 192.411 (2) within seven days after issuance of the order, or did not institute the proceedings within seven days after issuance of the notice, the petitioner shall be awarded costs of suit at the trial level and reasonable attorney fees regardless of which party instituted the suit and regardless of which party prevailed therein. [Formerly 192.490]
 
      442.420 Application for financial assistance; financial analysis and investigation authority; rules. (1) The Oregon Health Authority may apply for, receive and accept grants, gifts, payments and other funds and advances, appropriations, properties and services from the United States, the State of Oregon or any governmental body, agency or agencies or from any other public or private corporation or person, and enter into agreements with respect thereto, including the undertaking of studies, plans, demonstrations or projects.
      (2) The authority shall conduct or cause to have conducted such analyses and studies relating to costs of health care facilities as considered desirable, including but not limited to methods of reducing such costs, utilization review of services of health care facilities, peer review, quality control, financial status of any facility subject to ORS 442.400 to 442.463 and sources of public and private financing of financial requirements of such facilities.
      (3) The authority may also:
      (a) Hold public hearings, conduct investigations and require the filing of information relating to any matter affecting the costs of and charges for services in all health care facilities;
      (b) Subpoena witnesses, papers, records and documents the authority considers material or relevant in connection with functions of the authority subject to the provisions of ORS chapter 183;
      (c) Exercise, subject to the limitations and restrictions imposed by ORS 442.400 to 442.463, all other powers which are reasonably necessary or essential to carry out the express objectives and purposes of ORS 442.400 to 442.463; and
      (d) Adopt rules in accordance with ORS chapter 183 for carrying out the functions of the authority. [Formerly 441.435; 1981 c.693 §17; 1983 c.482 §15; 1985 c.747 §39; 1995 c.727 §26; 1997 c.683 §22; 1999 c.581 §4; 2015 c.318 §31]

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].

ORS 442.370

   442.370 Ambulatory surgery and inpatient discharge abstract records; rules; fees. (1) In order to provide data essential for health planning programs:

      (a) The Oregon Health Authority shall obtain directly from each hospital licensed to operate in this state, or from a third party working on behalf of or by contract with the hospital, the following information prescribed by the authority by rule:

      (A) Ambulatory surgery discharge abstract records;
      (B) Inpatient discharge abstract records; and
      (C) Emergency department discharge abstract records.

      (b) The authority shall obtain directly from each ambulatory surgical center licensed to operate in this state, or from a third party working on behalf of or by contract with the ambulatory surgical center, the following information prescribed by the authority by rule:

      (A) Ambulatory surgery discharge abstract records; and
      (B) Discharge abstract records of patients discharged from extended stay centers licensed under ORS 441.026 that are affiliated with the ambulatory surgical center.

      (2) The authority may establish by rule a fee to be charged to each ambulatory surgical center.
      (3) The fee established under subsection (2) of this section may not exceed the cost of abstracting and compiling the records.
      (4) The authority may specify by rule the form in which records are to be submitted. If the form adopted by rule requires conversion from the form regularly used by a hospital, ambulatory surgical center or extended stay center, reasonable costs of such conversion shall be paid by the authority.

      (5) The authority may provide by rule for the submission of ambulatory surgery, inpatient and emergency department discharge abstract records for enrollees in a health maintenance organization in a form the authority determines appropriate to the authority's needs for the data and the organization's record keeping and reporting systems for charges and services.

      (6) The authority shall notify any entity submitting data under this section of any changes to the data sets that must be submitted, no later than July 1 of the calendar year preceding the effective date of the changes.

      (7) The authority may contract with a third party to receive and process the records submitted under this section. [Formerly 442.120]​

ORS 442.361 to 442.362, 442.991


       442.361 Definitions for ORS 442.361, 442.362 and 442.991. As used in this section and ORS 442.362 and 442.991:
      (1)(a) "Capital project" means:
      (A) The construction, development, purchase, renovation or any construction expenditure by or on behalf of a reporting entity, for which the cost:
      (i) For type A hospitals, exceeds five percent of gross revenue.
      (ii) For type B hospitals, exceeds five percent of gross revenue.
      (iii) For DRG hospitals, exceeds 1.75 percent of gross revenue.
      (iv) For ambulatory surgery centers, exceeds $2 million.
      (B) The purchase or lease of, or other comparable arrangement for, a single piece of diagnostic or therapeutic equipment for which the cost or, in the case of a donation, the value exceeds $1 million. The acquisition of two or more pieces of diagnostic or therapeutic equipment that are necessarily interdependent in the performance of ordinary functions shall be combined in calculating the cost or value of the transaction.
      (b) "Capital project" does not include a project financed entirely through charitable fundraising.
      (2) "DRG hospital" means a hospital that is not a type A or type B hospital and that receives Medicare reimbursement based upon diagnostic related groups.
      (3) "Gross revenue" has the meaning given that term in ORS 442.015.
      (4) "Reporting entity" includes the following if licensed pursuant to ORS 441.015:
      (a) A type A hospital as described in ORS 442.470.
      (b) A type B hospital as described in ORS 442.470.
      (c) A DRG hospital.
      (d) An ambulatory surgical center as defined in ORS 442.015. [2009 c.595 §1197]
 
      Note: 442.361 and 442.362 were added to and made a part of ORS chapter 442 by legislative action but were not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 
      442.362 Reporting of proposed capital projects by hospitals and ambulatory surgical centers. The Oregon Health Authority may adopt rules requiring reporting entities within the state to publicly report proposed capital projects. Rules adopted under this section must:
      (1) Require a reporting entity to establish on the home page of its website a prominently labeled link to information about proposed or pending capital projects. The information posted must include but is not limited to a report of the community benefit for the project, its estimated cost and a means for interested persons to submit comments. When a reporting entity posts the information required under this subsection, the reporting entity must notify the authority of the posting in the manner prescribed by the authority.
      (2) If a reporting entity does not have a website, require the reporting entity to publish notice of the proposed capital project in a major newspaper or online equivalent serving the region in which the proposed capital project will be located. The notice must include but is not limited to a report of the community benefit for the project, its estimated cost and a means for interested persons to submit comments. When a reporting entity publishes the information required under this subsection, the reporting entity must notify the authority of the publication in the manner prescribed by the authority.
      (3) Establish a publicly available resource for information collected under this section. [2009 c.595 §1198; 2015 c.318 §30]
      Note: See note under 442.361.

      442.991 Civil penalties for failure to report proposed capital projects. (1) Any reporting entity that fails to report as required by rules of the Oregon Health Authority adopted pursuant to ORS 442.362 may be subject to a civil penalty.
      (2) The authority shall adopt a schedule of penalties, not to exceed $500 per day of violation, that are based on the severity of the violation.
      (3) Civil penalties imposed under this section shall be imposed as provided in ORS 183.745.
      (4) Civil penalties imposed under this section may be remitted or mitigated upon such terms and conditions as the authority considers proper and consistent with the public health and safety.
      (5) Civil penalties incurred under any law of this state are not allowable as costs for the purpose of rate determination or for reimbursement by a third-party payer. [2009 c.595 §1199; 2015 c.318 §38]
​​

ORS 4​42.601 to 442.630​

 
 442.601 Definitions. As used in this section and ORS 442.602:

      (1) “Charity care" means free or discounted health services provided to persons who cannot afford to pay and from whom a hospital has no expectation of payment. “Charity care" does not include bad debt, contractual allowances or discounts for quick payment.

      (2) “Community benefit" means a program or activity that provides treatment or promotes health and healing, addresses health disparities or addresses the social determinants of health in response to an identified community need. “Community benefit" includes:

      (a) Charity care;
      (b) Losses related to Medicaid, State Children's Health Insurance Program or other publicly funded health care program shortfalls other than Medicare;
      (c) Community health improvement services;
      (d) Research;
      (e) Financial and in-kind contributions to the community; and
      (f) Community building activities affecting health in the community.

      (3) “Social determinants of health" has the meaning given that term in ORS 442.612. [Formerly 442.200]

      442.602 Community benefit reporting; rules. 

      (1) The Oregon Health Authority shall by rule adopt a cost-based community benefit reporting system for hospitals operating in Oregon that is consistent with established national standards for hospital reporting of community benefits.

      (2) Within 90 days of filing a Medicare cost report, a hospital must submit a community benefit report to the authority of the community benefits provided by the hospital, on a form prescribed by the authority.

      (3) The authority shall produce an annual report of the information provided under subsections (1) and (2) of this section. The report shall be submitted to the Governor, the President of the Senate and the Speaker of the House of Representatives. The report shall be presented to the Legislative Assembly during each odd-numbered year regular session and shall be made available to the public.

      (4) The authority may adopt all rules necessary to carry out the provisions of this section. [Formerly 442.205]

(Financial Assistance Policies)

      442.610 Notice of financial assistance policies. 

      (1) As used in this section:

      (a) “Financial assistance policy" means a policy that meets the requirements of section 501(r) of the Internal Revenue Code and implementing regulations.
      (b) “Hospital" has the meaning given that term in ORS 442.015.

      (2) A hospital shall have a written financial assistance policy that complies with the plain language standards for consumer contracts under ORS 180.545 (1).

      (3) A hospital shall:

      (a) Provide a paper copy of the financial assistance policy to a patient upon request;
      (b) Include on each billing statement notice of:

      (A) The availability of financial assistance;
      (B) The contact information for the office or department of the hospital that can provide information about obtaining financial assistance; and
      (C) The direct Internet address for the financial assistance policy; and

      (c) Maintain public displays in locations in the hospital that are accessible to the public that notify and inform patients about the financial assistance policy. Locations that are accessible to the public include but are not limited to the emergency department, if any, and the areas where patient admissions are processed.

      (4) The Oregon Health Authority shall make available to hospitals and the general public a uniform application for financial assistance, created by a trade association representing hospitals, that may be used in any hospital in this state to request financial assistance. [2018 c.50 §9; 2018 c.50 §10]

 

      Note: 442.610 to 442.630 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 442 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.

 

      442.612 Definitions. As used in ORS 442.612 to 442.630 and 646A.677:

      (1) “Adjust" means to reduce a patient's cost by a specified percentage.

      (2) “Community benefit" has the meaning given that term in ORS 442.601.

      (3) “Gross charges" means a hospital's full, established price for medical care that the hospital consistently and uniformly charges patients before applying any contractual allowance, discounts or deductions.

      (4)(a) “Hospital" has the meaning given that term in ORS 442.015, excluding any campus of the Oregon State Hospital, a hospital operated by the United States Department of Veterans Affairs Veterans Health Administration or any other hospital operated by the federal government.
      (b) “Hospital" includes only hospitals located in this state.

      (5) “Hospital-affiliated clinic" or “affiliated clinic" means a facility located in this state that provides outpatient health services and that is operated under the common control or ownership of a hospital.

      (6) “Household" means:

      (a)(A) A single individual; or
      (B) Spouses, domestic partners, or a parent and child under 18 years of age, living together; and
      (b) Other individuals for whom a single individual, spouse, domestic partner or parent is financially responsible.

      (7) “Medically necessary" means:

      (a) Necessary to prevent, diagnose or treat an illness, injury, condition or disease, or the symptoms of an illness, injury, condition or disease; and
      (b) Meeting accepted standards of medicine.

      (8) “Nonprofit" means:

      (a) Organized not for profit, pursuant to ORS chapter 65 or any predecessor of ORS chapter 65; or
      (b) Organized and operated as described under section 501(c) of the Internal Revenue Code as defined in ORS 305.842.

      (9) “Patient's cost" means the portion of charges billed to a patient for care received at a hospital or a hospital-affiliated clinic that are not reimbursed by insurance or a publicly funded health care program, taking into account the requirements of section 501(r)(5) of the Internal Revenue Code that:

      (a) Prohibit a nonprofit hospital from billing gross charges; and
      (b) Limit amounts charged for emergency or other medically necessary care, to a patient who qualifies under the nonprofit hospital's financial assistance policy, to no more than amounts generally billed to a patient who has insurance that reimburses all or a portion of the cost of the care.

      (10) “Social determinants of health" means the social, economic and environmental conditions in which people are born, grow, work, live and age, shaped by the distribution of money, power and resources at local, national and global levels, institutional bias, discrimination, racism and other factors. [2019 c.497 §1]

      Note: See note under 442.610.

      442.614 Requirements for financial assistance policies. A nonprofit hospital's written financial assistance policy described in ORS 442.610 must:

      (1) Provide for adjusting a patient's costs as follows:

      (a) For a patient whose household income is not more than 200 percent of the federal poverty guidelines, by 100 percent; and
      (b) For a patient whose household income is more than 200 percent of the federal poverty guidelines and not more than 400 percent of the federal poverty guidelines, the hospital shall adopt a policy establishing an adjustment based on a sliding scale;

      (2) Apply to all of the hospital's nonprofit affiliated clinics;

      (3) Be translated into each language spoken by the lesser of 1,000 people or five percent of the population that resides in the nonprofit hospital's service area;

      (4) Ensure that interpreter services are available to translate the policy into languages other than those described in subsection (3) of this section; and

      (5) Apply to all medically necessary services or supplies. [2019 c.497 §2]

      Note: The amendments to 442.614 by section 3, chapter 497, Oregon Laws 2019, become operative January 1, 2021. See section 14, chapter 497, Oregon Laws 2019. The text that is operative on and after January 1, 2021, is set forth for the user's convenience.

      442.614. A nonprofit hospital's written financial assistance policy described in ORS 442.610 must:

      (1) Provide for adjusting a patient's costs as follows:

      (a) For a patient whose household income is not more than 200 percent of the federal poverty guidelines, by 100 percent;
      (b) For a patient whose household income is more than 200 percent of the federal poverty guidelines and not more than 300 percent of the federal poverty guidelines, by a minimum of 75 percent;
      (c) For a patient whose household income is more than 300 percent of the federal poverty guidelines and not more than 350 percent of the federal poverty guidelines, by a minimum of 50 percent; and
      (d) For a patient whose household income is more than 350 percent of the federal poverty guidelines and not more than 400 percent of the federal poverty guidelines, by a minimum of 25 percent;

      (2) Apply to all of the hospital's nonprofit affiliated clinics;

      (3) Be translated into each language spoken by the lesser of 1,000 people or five percent of the population that resides in the nonprofit hospital's service area;

      (4) Ensure that interpreter services are available to translate the policy into languages other than those described in subsection (3) of this section; and

      (5) Apply to all medically necessary services or supplies.

      Note: See note under 442.610.

      442.618 Annual reports related to financial assistance policies and nonprofit status; penalties. 

      (1) As used in this section, “health care facility" has the meaning given that term in ORS 442.015, excluding long term care facilities.

      (2) A hospital shall report annually to the Oregon Health Authority the following information regarding all health care facilities and affiliated clinics that are owned in part or in full by the hospital or operating under the same brand as the hospital:

      (a) The address of each health care facility and affiliated clinic;
      (b) Whether the hospital's financial assistance policy, developed under ORS 442.614, is posted in the health care facility and affiliated clinic and available to patients of the facility and affiliated clinic; and
      (c) Whether the hospital is a nonprofit entity and whether the hospital's nonprofit status applies to the hospital's affiliated clinics.

      (3) The authority shall prescribe the form and manner for reporting the information described in subsection (2) of this section.

      (4) A hospital that fails to file a timely report, as prescribed by the authority, may be subject to a civil penalty not to exceed $500 per day. Civil penalties shall be imposed as provided in ORS 183.745. [2019 c.497 §7]

      Note: See note under 442.610.

(Community Benefit Spending)

      442.624 Establishment of community benefit spending floor; rules. 

      (1) Every two years, the Oregon Health Authority shall establish a community benefit spending floor as provided in this section based on objective data and criteria, including but not limited to the following:

      (a) Historical and current expenditures on community benefits by the hospital and the hospital's affiliated clinics.
      (b) Community needs identified in the community needs assessment conducted by the hospital in accordance with section 501(r)(3) of the Internal Revenue Code, and community health assessments and community health improvement plans of coordinated care organizations that serve the same geographic area served by the hospital and the hospital's affiliated clinics, in accordance with ORS 414.575 and 414.578.
      (c) The hospital's need to expand the health care workforce.
      (d) The overall financial position of the hospital and the hospital's affiliated clinics based on audited financial statements and other objective data.
      (e) The demographics of the population in the areas served by the hospital and the hospital's affiliated clinics.
      (f) The spending on the social determinants of health by the hospital or the hospital's affiliated clinics.
      (g) Taxes paid by the hospital and the hospital's payments, in lieu of taxes, paid to:

      (A) A local government;
      (B) The state; or
      (C) The United States government.

      (h) Criteria governing the manner in which the authority will consider input received from the general public under subsection (2)(c) of this section.
      (i) The hospital's obligations and commitments, as reported to the Internal Revenue Service, to:

      (A) Fund, support or provide health professions education; and
      (B) Fund health research.

      (j) For the Oregon Health and Science University hospital, its obligation to carry out the public purposes and missions specified in ORS 353.030.

      (2) In establishing the community benefit spending floors under subsection (1) of this section, the authority shall:

      (a) Consult with representatives of hospitals;
      (b) Provide an opportunity for hospitals and hospital-affiliated clinics to respond to any findings;
      (c) Solicit and consider comments from the general public; and
      (d) Consult with or solicit advice from one or more individuals with expertise in the economics of health care.

      (3) The authority shall adopt by rule alternative methodologies for hospitals and hospital-affiliated clinics to report data and to apply the community benefit spending floors, including but not limited to:

      (a) By each individual hospital and all of the hospital's nonprofit affiliated clinics;
      (b) By a hospital and a group of the hospital's nonprofit affiliated clinics; and
      (c) By all hospitals that are under common ownership and control and all of the hospitals' nonprofit affiliated clinics.

      (4) Each hospital shall be provided the opportunity to select the applicable methodology from those adopted by the authority by rule under subsection (3) of this section.

      (5) The authority may adopt rules necessary to carry out the provisions of this section. [2019 c.497 §6]

      Note: 442.624 becomes operative January 1, 2021. See section 14, chapter 497, Oregon Laws 2019.

      Note: See note under 442.610.

      442.625 [1999 c.1056 §3; renumbered 442.870 in 2019]

(Community Health Needs)

      442.630 Community health needs assessment and three-year strategy; public participation. A nonprofit hospital shall post to the hospital's website the following information regarding its community health needs assessment conducted in accordance with section 501(r)(3) of the Internal Revenue Code:

      (1) A description of the health care needs identified in the hospital's community health needs assessment;

      (2) The three-year strategy developed to address the health care needs of the community;

      (3) Annual progress on the implementation of the strategy; and

      (4) Opportunities for public participation in the assessment and development of the strategy. [2019 c.497 §5]

​      Note: See note under 442.610.

      Note: Section 12, chapter 497, Oregon Laws 2019, provides:

      Sec. 12. No later than December 31, 2022, the Oregon Health Authority shall report to the interim committees of the Legislative Assembly related to health on the implementation of sections 1 to 7 of this 2019 Act [442.612 to 442.630 and 646A.677] and the amendments to ORS 442.200 by section 10 of this 2019 Act. [2019 c.497 §12]

 

ORS 441.056, 441.221 to 441.233

      441.056 Credentialing telemedicine providers. (1) The Oregon Health Authority shall prescribe by rule the information and documents that a governing body of an originating-site hospital may request for credentialing a telemedicine provider located at a distant-site hospital.

      (2) The rules adopted by the authority under subsection (1) of this section must:
      (a) Prescribe a standard list of information and documents that shall be provided by a distant-site hospital;
      (b) Prescribe a list of information and documents that may be requested by an originating-site hospital in addition to the standard list of information and documents;
      (c) Prescribe a list of information and documents that may not be requested by an originating-site hospital; and
      (d) Be consistent with all applicable legal and accreditation requirements of an originating-site hospital and the health plans with which the originating-site hospital contracts.
      (3) Except as provided in subsection (4) of this section, an originating-site hospital in this state must comply with the rules adopted under this section if the telemedicine provider is located at a distant-site hospital that is located in this state. This section does not prevent hospitals located outside of this state from using or require such hospitals to use the prescribed list of information and documents in credentialing a telemedicine provider.
      (4) An originating-site hospital is not limited to the information and documents prescribed by the authority if the originating-site hospital has a delegated credentialing agreement with the distant-site hospital where the telemedicine provider is located and the governing body of the originating-site hospital accepts the recommendation of the medical staff to credential the telemedicine provider.
      (5) In the adoption of the rules described in subsections (1) and (2) of this section, the authority shall consult with representatives of distant-site hospitals and originating-site hospitals in this state. Once adopted, the authority may not amend the rules to alter the prescribed lists without first consulting representatives of distant-site hospitals and originating-site hospitals in this state.
      (6) This section does not affect the responsibilities of a governing body under ORS 441.055 and does not require a governing body of a hospital to grant privileges to a telemedicine provider. [2013 c.414 §2]
      Note: 441.056 was added to and made a part of ORS chapter 441 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.
 

ADVISORY COMMITTEE ON PHYSICIAN CREDENTIALING INFORMATION

      441.221 Advisory Committee on Physician Credentialing Information; membership; terms. (1) The Advisory Committee on Physician Credentialing Information is established within the Oregon Health Authority. The committee consists of nine members appointed by the Director of the Oregon Health Authority as follows:
      (a) Three members who are health care practitioners licensed by the Oregon Medical Board or representatives of health care practitioners' organizations doing business within the State of Oregon;
      (b) Three representatives of hospitals licensed by the Oregon Health Authority; and
      (c) Three representatives of health care service contractors that have been issued a certificate of authority to transact health insurance in this state by the Department of Consumer and Business Services.
      (2) All members appointed pursuant to subsection (1) of this section shall be knowledgeable about national standards relating to the credentialing of health care practitioners.
      (3) The term of appointment for each member of the committee is three years. If, during a member's term of appointment, the member no longer qualifies to serve as designated by the criteria of subsection (1) of this section, the member must resign. If there is a vacancy for any cause, the director shall make an appointment to become immediately effective for the unexpired term.
      (4) Members of the committee are not entitled to compensation or reimbursement of expenses. [Formerly 442.800; 2015 c.318 §25]
      Note: 441.221 to 441.223 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 441 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
      441.222 Committee recommendations. (1) The Advisory Committee on Physician Credentialing Information shall develop and submit recommendations to the Director of the Oregon Health Authority for the collection of uniform information necessary for credentialing organizations to credential health care practitioners seeking designation as a participating provider or member of a credentialing organization. The recommendations must specify:
      (a) The content and format of a credentialing application form; and
      (b) The content and format of a recredentialing application form.
      (2) The committee shall meet at least once every calendar year to review the uniform credentialing information and to assure the director that the information complies with credentialing standards developed by national accreditation organizations and applicable regulations of the federal government.
      (3) The Oregon Health Authority shall provide the support staff necessary for the committee to accomplish its duties. [Formerly 442.805; 2015 c.318 §26]
      Note: See note under 441.221.
      441.223 Implementation of committee recommendations; rules. (1) Upon receiving the recommendations of the Advisory Committee on Physician Credentialing Information, the Oregon Health Authority shall:
      (a) Adopt administrative rules in a timely manner, as required by the Administrative Procedures Act, for the purpose of effectuating the provisions of ORS 441.221 to 441.223;
      (b) Consult with the advisory group convened under ORS 441.232 to review the recommendations and obtain advice on the rules; and
      (c) Ensure that the rules adopted by the Oregon Health Authority are identical and are consistent with the recommendations developed pursuant to ORS 441.222 for affected credentialing organizations.
      (2) The uniform credentialing information required pursuant to the administrative rules of the Oregon Health Authority represents the minimum uniform credentialing information required by the affected credentialing organizations. Except as provided in subsection (3) of this section, a credentialing organization may request additional credentialing information from a health care practitioner for the purpose of completing credentialing procedures used by the credentialing organization to credential health care practitioners.
      (3) In credentialing a telemedicine provider, a hospital is subject to the requirements prescribed by rule by the authority under ORS 441.056. [Formerly 442.807]
      Note: See note under 441.221.

 

ELECTRONIC CREDENTIALING INFORMATION

      441.224 Definitions for ORS 441.224 to 441.233. As used in ORS 441.224 to 441.233:

      (1) "Credentialing information" means information necessary to credential or recredential a health care practitioner.

      (2) "Credentialing organization" means a hospital or other health care facility, physician organization or other health care provider organization, coordinated care organization, business organization, insurer or other organization that credentials health care practitioners.

      (3) "Health care practitioner" means an individual authorized to practice a profession related to the provision of health care services in this state for which the individual must be credentialed.

      (4) "Health care regulatory board" means a board or other agency that authorizes individuals to practice a profession related to the provision of health care services for which the individual must be credentialed. [2013 c.603 §2]

      441.225 [Repealed by 1971 c.727 §203]

      441.226 Electronic credentialing information program.

(1)(a) The Oregon Health Authority, in consultation with the advisory work group convened under ORS 441.232, shall establish a program for the purpose of providing to a credentialing organization access to information that is necessary to credential or recredential a health care practitioner.

      (b) To fulfill the requirements of this subsection, the authority shall establish and operate an electronic system through which credentialing information may be submitted to an electronic database and accessed. The system must operate and be accessible by credentialing organizations, health care practitioners and health care regulatory boards 24 hours a day, seven days a week. The authority may contract with a private entity to ensure the effective establishment and operation of the system.

      (c) To the greatest extent practicable, the electronic system shall use the most accessible and current technology available.

      (2) In consultation with the advisory work group convened under ORS 441.232, the authority shall adopt rules for the operation of the electronic system, including:

      (a) Identification of the type of information that is necessary to credential or recredential each type of health care practitioner;

      (b) Processes by which a health care practitioner or health care regulatory board submits credentialing information to the authority or an entity that has entered into a contract with the authority under subsection (1)(b) of this section;

      (c) Processes, as required by recognized state and national credentialing standards, by which credentialing information submitted under ORS 441.228 is verified;

      (d) Processes by which a credentialing organization, health care practitioner or health care regulatory board may electronically access the database;

      (e) Processes by which a health care practitioner may attest that the credentialing information in the electronic database is current;

      (f) The purposes for which credentialing information accessed by a credentialing organization or health care regulatory board may be used; and

      (g) The imposition of fees, not to exceed the cost of administering ORS 441.224 to 441.233, on health care practitioners who submit credentialing information to the database and credentialing organizations that access the database.

      (3) All information, except for general information used for directories, as defined by the authority by rule, that is received, kept and maintained in the database under this section is exempt from public disclosure under ORS 192.410 to 192.505. [2013 c.603 §3]

      441.227 [1965 c.403 §2; 1969 c.343 §5; repealed by 1971 c.727 §203]

      441.228 Submission of credentialing information; civil immunity. (1)(a) As a condition of being authorized to practice a profession in this state, a health care practitioner or designee must submit to the Oregon Health Authority, an entity that has entered into a contract with the authority under ORS 441.226 (1)(b) or a health care regulatory board the credentialing information identified by the authority under ORS 441.226 (2)(a).

      (b) A health care practitioner that, in good faith, submits credentialing information under this subsection is immune from civil liability that might otherwise be incurred or imposed with respect to the submission of that credentialing information.

      (2) The authority may require a health care regulatory board, after consulting with the health care regulatory board, to provide or supplement the credentialing information identified by the authority under ORS 441.226 (2)(a).

      (3)(a) A credentialing organization shall obtain from the authority, or an entity that has entered into a contract with the authority under ORS 441.226 (1)(b), the credentialing information of the health care practitioner that is kept and maintained in the electronic database described in ORS 441.226. A credentialing organization may not request credentialing information from a health care practitioner if the credentialing information is available through the database. However, nothing in ORS 441.224 to 441.233 shall prevent a credentialing organization from requesting additional credentialing information from a health care practitioner for the purpose of completing credentialing procedures for the health care practitioner used by the credentialing organization.

      (b) A credentialing organization that, in good faith, uses credentialing information provided under this subsection for the purposes established by the authority under ORS 441.226 (2)(e) is immune from civil liability that might otherwise be incurred or imposed with respect to the use of that credentialing information. [2013 c.603 §4]

      441.229 Exemption from electronic credentialing information program. A prepaid group practice health plan that serves at least 200,000 members in this state and that has been issued a certificate of authority by the Department of Consumer and Business Services may petition the Director of the Oregon Health Authority to be exempt from the requirements of ORS 441.224 to 441.233. The director may award the petition if the director determines that subjecting the health plan to ORS 441.224 to 441.233 is not cost-effective. If a petition is awarded under this section, the exemption also applies to any health care facilities and health care provider groups associated with the health plan. [2013 c.603 §5]

      441.230 [Amended by 1965 c.403 §3; 1969 c.343 §6; repealed by 1971 c.727 §203]

      441.232 Advisory group. At least once per year, the Oregon Health Authority shall convene an advisory group consisting of individuals who represent credentialing organizations, health care practitioners and health care regulatory boards to review and advise the authority on the implementation of ORS 441.224 to 441.233 and on the standard credentialing application used in this state. [2013 c.603 §7]

      441.233 Rules. The Director of the Oregon Health Authority shall adopt rules necessary for the administration of ORS 441.224 to 441.233. [2013 c.603 §6]

      Note: Section 2, chapter 297, Oregon Laws 2015, provides:

      Sec. 2. (1) As used in this section, "credentialing information," "credentialing organization," "health care practitioner" and "health care regulatory board" have the meanings given those terms in section 2, chapter 603, Oregon Laws 2013 [441.224].

      (2) Notwithstanding section 4 (1), chapter 603, Oregon Laws 2013 [441.228 (1)], a health care practitioner is not required to submit credentialing information to the program established by the Oregon Health Authority under section 3, chapter 603, Oregon Laws 2013 [441.226], and submission of the credentialing information is not a condition of being authorized to practice a profession in this state, until both of the following have occurred:

      (a) The authority has established an operational electronic system through which credentialing information may be submitted; and

      (b) The date has passed by which the authority requires by rule that type of health care practitioner to submit the credentialing information.

      (3) Before adopting rules under subsection (2) of this section, the authority shall consult the advisory work group described in section 7, chapter 603, Oregon Laws 2013 [441.232], about the date by which each type of health care practitioner should be required to submit the credentialing information.

      (4) Notwithstanding ORS 183.335 (1), notice of a rule adopted under subsection (2) of this section must be provided at least six months before the effective date of the rule:

      (a) By electronic mail to credentialing organizations represented in the advisory work group described in section 7, chapter 603, Oregon Laws 2013; and

      (b) By electronic mail to the health care regulatory board that is responsible for regulating the type of health care practitioner to whom the rule applies. [2015 c.297 §2]

ORS 442.372, 442.373, 442.993

442.372 Definitions for ORS 442.372 and 442.373. As used in this section and ORS 442.373, “reporting entity” means:
      (1) An insurer as defined in ORS 731.106 or fraternal benefit society as described in ORS 748.106 required to have a certificate of authority to transact health insurance business in this state.
      (2) A health care service contractor as defined in ORS 750.005 that issues medical insurance in this state.
      (3) A third party administrator required to obtain a license under ORS 744.702.
      (4) A pharmacy benefit manager or fiscal intermediary, or other person that is by statute, contract or agreement legally responsible for payment of a claim for a health care item or service.
      (5) A coordinated care organization as defined in ORS 414.025.
      (6) An insurer providing coverage funded under Part A, Part B or Part D of Title XVIII of the Social Security Act, subject to approval by the United States Department of Health and Human Services. [Formerly 442.464]
 
      Note: 442.372 and 442.373 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 442 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
 
      442.373 Health care data reporting by health insurers; rules; fees. (1) The Oregon Health Authority shall establish and maintain a program that requires reporting entities to report health care data for the following purposes:
      (a) Determining the maximum capacity and distribution of existing resources allocated to health care.
      (b) Identifying the demands for health care.
      (c) Allowing health care policymakers to make informed choices.
      (d) Evaluating the effectiveness of intervention programs in improving health outcomes.
      (e) Comparing the costs and effectiveness of various treatment settings and approaches.
      (f) Providing information to consumers and purchasers of health care.
      (g) Improving the quality and affordability of health care and health care coverage.
      (h) Assisting the authority in furthering the health policies expressed by the Legislative Assembly in ORS 442.310.
      (i) Evaluating health disparities, including but not limited to disparities related to race and ethnicity.
      (2) The authority shall prescribe by rule standards that:
      (a) Establish the time, place, form and manner of reporting data under this section, including but not limited to:
      (A) Requiring the use of unique patient and provider identifiers;
      (B) Specifying a uniform coding system that reflects all health care utilization and costs for health care services provided to Oregon residents in other states; and
      (C) Establishing enrollment thresholds below which reporting will not be required.
      (b) Establish the types of data to be reported under this section, including but not limited to:
      (A) Health care claims and enrollment data used by reporting entities and paid health care claims data;
      (B) Reports, schedules, statistics or other data relating to health care costs, prices, quality, utilization or resources determined by the authority to be necessary to carry out the purposes of this section; and
      (C) Data related to race, ethnicity, disability, sexual orientation, gender identity and primary language collected in a manner consistent with ORS 413.161.
      (3) Any third party administrator that is not required to obtain a license under ORS 744.702 and that is legally responsible for payment of a claim for a health care item or service provided to an Oregon resident may report to the authority the health care data described in subsection (2) of this section.
      (4) The authority shall adopt rules establishing requirements for reporting entities to train providers on protocols for collecting race, ethnicity, disability, sexual orientation, gender identity and primary language data in a culturally competent manner.
      (5)(a) The authority shall use data collected under this section to provide information to consumers of health care to empower the consumers to make economically sound and medically appropriate decisions. The information must include, but not be limited to, the prices and quality of health care services.
      (b) The authority shall, using only data collected under this section from reporting entities described in ORS 442.372 (1) to (3), post to its website health care price information including the median prices paid by the reporting entities to hospitals and hospital outpatient clinics for, at a minimum, the 50 most common inpatient procedures and the 100 most common outpatient procedures.
      (c) The health care price information posted to the website must be:
      (A) Displayed in a consumer friendly format;
      (B) Easily accessible by consumers; and
      (C) Updated at least annually to reflect the most recent data available.
      (d) The authority shall apply for and receive donations, gifts and grants from any public or private source to pay the cost of posting health care price information to its website in accordance with this subsection. Moneys received shall be deposited to the Oregon Health Authority Fund.
      (e) The obligation of the authority to post health care price information to its website as required by this subsection is limited to the extent of any moneys specifically appropriated for that purpose or available from donations, gifts and grants from private or public sources.
      (6) The authority may contract with a third party to collect and process the health care data reported under this section. The contract must prohibit the collection of Social Security numbers and must prohibit the disclosure or use of the data for any purpose other than those specifically authorized by the contract. The contract must require the third party to transmit all data collected and processed under the contract to the authority.
      (7) The authority shall facilitate a collaboration between the Department of Human Services, the authority, the Department of Consumer and Business Services and interested stakeholders to develop a comprehensive health care information system using the data reported under this section and collected by the authority under ORS 442.370 and 442.400 to 442.463. The authority, in consultation with interested stakeholders, shall:
      (a) Formulate the data sets that will be included in the system;
      (b) Establish the criteria and procedures for the development of limited use data sets;
      (c) Establish the criteria and procedures to ensure that limited use data sets are accessible and compliant with federal and state privacy laws; and
      (d) Establish a time frame for the creation of the comprehensive health care information system.
      (8) Information disclosed through the comprehensive health care information system described in subsection (7) of this section:
      (a) Shall be available, when disclosed in a form and manner that ensures the privacy and security of personal health information as required by state and federal laws, as a resource to researchers, insurers, employers, providers, purchasers of health care and state agencies to allow for continuous review of health care utilization, expenditures and performance in this state;
      (b) Shall be available to Oregon programs for quality in health care for use in improving health care in Oregon, subject to rules prescribed by the authority conforming to state and federal privacy laws or limiting access to limited use data sets;
      (c) Shall be presented to allow for comparisons of geographic, demographic and economic factors and institutional size; and
      (d) May not disclose trade secrets of reporting entities or self-funded, employer-sponsored health insurance plans regulated under the Employee Retirement Income Security Act of 1974, as codified and amended at 29 U.S.C. 1001, et seq., that report health care data voluntarily.
      (9) The collection, storage and release of health care data and other information under this section is subject to the requirements of the federal Health Insurance Portability and Accountability Act.
      (10)(a) Notwithstanding subsection (9) of this section, in addition to the comprehensive health care information system described in subsection (7) of this section, the Department of Consumer and Business Services shall be allowed to access, use and disclose data collected under this section by certifying in writing that the data will be used only to carry out the department’s duties.
      (b) Personally identifiable information disclosed to the department under paragraph (a) of this subsection, including a consumer’s name, address, telephone number or electronic mail address, is confidential and not subject to further disclosure under ORS 192.311 to 192.478.
      (11) The authority may impose a charge for information disclosed to researchers, insurers, employers, providers and purchasers of health care under subsection (8) of this section in an amount necessary to cover the authority’s actual costs for collecting and releasing the information that is requested. [Formerly 442.466; 2021 c.205 §4; 2023 c.584 §1]
 
      Note: See note under 442.372.
 442.993 Civil penalties for failure to report health care data. (1) The Oregon Health Authority shall adopt a schedule of civil penalties not to exceed $500 per day of violation, determined by the severity of the violation, for:
      (a) Any reporting entity that fails to report as required by ORS 442.373 or rules adopted by the authority.
      (b) Any provider or payer that fails to report cost growth data or to develop and implement a performance improvement plan if required by ORS 442.386 or rules adopted by the authority.
      (2) Civil penalties under this section shall be imposed as provided in ORS 183.745.
      (3) Civil penalties imposed under this section may be remitted or mitigated upon such terms and conditions as the authority considers proper and consistent with the public health and safety.
      (4) Civil penalties incurred under any law of this state are not allowable as costs for the purpose of rate determination or for reimbursement by a third-party payer.
      (5) Moneys collected from providers and payers described in subsection (1)(b) of this section shall be deposited in the Oregon Health Authority Fund established by ORS 413.101 and used by the authority to support programs that expand access to health care and that support populations adversely affected by high health care costs. [2009 c.595 §1202; 2015 c.318 §39; 2015 c.845 §2; 2021 c.51 §6]
 
      Note: 442.993 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 442 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.​ ​

ORS 442.400 to 442.463


     442.400 "Health care facility" defined. As used in ORS 442.400 to 442.463, unless the context requires otherwise, "health care facility" or "facility" means such facility as defined by ORS 442.015, exclusive of a long term care facility, and includes all publicly and privately owned and operated health care facilities, but does not include facilities described in ORS 441.065. [Formerly 441.415; 1979 c.697 §8; 1981 c.693 §15]
 
      442.405 Legislative findings and policy. The Legislative Assembly finds that rising costs and charges of health care facilities are a matter of vital concern to the people of this state. The Legislative Assembly finds and declares that it is the policy of this state:
      (1) To require health care facilities to file for public disclosure reports that will enable both private and public purchasers of services from such facilities to make informed decisions in purchasing such services; and
      (2) To encourage development of programs of research and innovation in the methods of delivery of institutional health care services of high quality with costs and charges reasonably related to the nature and quality of the services rendered. [Formerly 441.420; 1999 c.581 §3]
 
      442.420 Application for financial assistance; financial analysis and investigation authority; rules. (1) The Oregon Health Authority may apply for, receive and accept grants, gifts, payments and other funds and advances, appropriations, properties and services from the United States, the State of Oregon or any governmental body, agency or agencies or from any other public or private corporation or person, and enter into agreements with respect thereto, including the undertaking of studies, plans, demonstrations or projects.

 

      (2) The authority shall conduct or cause to have conducted such analyses and studies relating to costs of health care facilities as considered desirable, including but not limited to methods of reducing such costs, utilization review of services of health care facilities, peer review, quality control, financial status of any facility subject to ORS 442.400 to 442.463 and sources of public and private financing of financial requirements of such facilities.

 

      (3) The authority may also:

 

      (a) Hold public hearings, conduct investigations and require the filing of information relating to any matter affecting the costs of and charges for services in all health care facilities;

 

      (b) Subpoena witnesses, papers, records and documents the authority considers material or relevant in connection with functions of the authority subject to the provisions of ORS chapter 183;

 

      (c) Exercise, subject to the limitations and restrictions imposed by ORS 442.400 to 442.463, all other powers which are reasonably necessary or essential to carry out the express objectives and purposes of ORS 442.400 to 442.463; and

 

      (d) Adopt rules in accordance with ORS chapter 183 for carrying out the functions of the authority. [Formerly 441.435; 1981 c.693 §17; 1983 c.482 §15; 1985 c.747 §39; 1995 c.727 §26; 1997 c.683 §22; 1999 c.581 §4; 2015 c.318 §31]
 
      442.425 Financial reporting systems. (1) The Oregon Health Authority by rule may specify one or more uniform systems of financial reporting necessary to meet the requirements of ORS 442.400 to 442.463. Such systems shall include such cost allocation methods as may be prescribed and such records and reports of revenues, expenses, other income and other outlays, assets and liabilities, and units of service as may be prescribed. Each facility under the authority's jurisdiction shall adopt such systems for its fiscal period starting on or after the effective date of such system and shall make the required reports on such forms as may be required by the authority. The authority may extend the period by which compliance is required upon timely application and for good cause. Filings of such records and reports shall be made at such times as may be reasonably required by the authority.

 

      (2) Existing systems of reporting used by health care facilities shall be given due consideration by the authority in carrying out the duty of specifying the systems of reporting required by ORS 442.400 to 442.463. The authority insofar as reasonably possible shall adopt reporting systems and requirements that will not unreasonably increase the administrative costs of the facility.

 

      (3) The authority may allow and provide for modifications in the reporting systems in order to correctly reflect differences in the scope or type of services and financial structure between the various categories, sizes or types of health care facilities and in a manner consistent with the purposes of ORS 442.400 to 442.463.

 

      (4) The authority may establish specific annual reporting provisions for facilities that receive a preponderance of their revenue from associated comprehensive group-practice prepayment health care service plans. Notwithstanding any other provisions of ORS 442.400 to 442.463, such facilities shall be authorized to utilize established accounting systems and to report costs and revenues in a manner consistent with the operating principles of such plans and with generally accepted accounting principles. When such facilities are operated as units of a coordinated group of health facilities under common ownership, the facilities shall be authorized to report as a group rather than as individual institutions, and as a group shall submit a consolidated balance sheet, income and expense statement and statement of source and application of funds for such group of health facilities. [Formerly 441.440; 1981 c.693 §18; 1995 c.727 §27; 1997 c.683 §23; 1999 c.581 §5; 2009 c.792 §40; 2015 c.318 §32]


      442.430 Investigations; confidentiality of data. (1) Whenever a further investigation is considered necessary or desirable by the Oregon Health Authority to verify the accuracy of the information in the reports made by health care facilities, the authority may make any necessary further examination of the facility's records and accounts. Such further examinations include, but are not limited to, requiring a full or partial audit of all such records and accounts.


      (2) In carrying out the duties prescribed by ORS 442.400 to 442.463, the authority may utilize its own staff or may contract with any appropriate, independent, qualified third party. No such contractor shall release or publish or otherwise use any information made available to it under its contractual responsibility unless such permission is specifically granted by the authority. [Formerly 441.445; 1995 c.727 §28; 1997 c.683 §24; 2009 c.792 §41; 2015 c.318 §33]

 

      442.445 Civil penalty for failure to perform. (1) Any health care facility that fails to perform as required in ORS 442.205 and 442.400 to 442.463 or section 3, chapter 838, Oregon Laws 2007, and rules of the Oregon Health Authority may be subject to a civil penalty.
      (2) The Oregon Health Authority shall adopt a schedule of penalties not to exceed $500 per day of violation, determined by the severity of the violation.
      (3) Civil penalties under this section shall be imposed as provided in ORS 183.745.
      (4) Civil penalties imposed under this section may be remitted or mitigated upon such terms and conditions as the authority considers proper and consistent with the public health and safety.
      (5) Civil penalties incurred under any law of this state are not allowable as costs for the purpose of rate determination or for reimbursement by a third-party payer. [Formerly 441.480; 1981 c.693 §19; 1983 c.482 §18; 1983 c.696 §21; 1991 c.734 §24; 1993 c.18 §110; 1995 c.727 §30; 1997 c.683 §26; 1999 c.581 §6; 2007 c.384 §4; 2007 c.838 §7; 2013 c.61 §2b]
 
      Note: The amendments to 442.445 by section 8, chapter 838, Oregon Laws 2007, become operative January 2, 2018. See section 9, chapter 838, Oregon Laws 2007. The text that is operative on and after January 2, 2018, including amendments by section 2c, chapter 61, Oregon Laws 2013, is set forth for the user's convenience.
      442.445. (1) Any health care facility that fails to perform as required in ORS 442.205 and 442.400 to 442.463 and rules of the Oregon Health Authority may be subject to a civil penalty.
      (2) The Oregon Health Authority shall adopt a schedule of penalties not to exceed $500 per day of violation, determined by the severity of the violation.
      (3) Civil penalties under this section shall be imposed as provided in ORS 183.745.
      (4) Civil penalties imposed under this section may be remitted or mitigated upon such terms and conditions as the authority considers proper and consistent with the public health and safety.
      (5) Civil penalties incurred under any law of this state are not allowable as costs for the purpose of rate determination or for reimbursement by a third-party payer.
  
      442.450 Exemption from cost review regulations. The following are not subject to ORS 442.400 to 442.463:
      (1) Physicians in private practice, solo or in a group or partnership, who are not employed by, or hold ownership or part ownership in, a health care facility; or
      (2) Health care facilities described in ORS 441.065. [1977 c.751 §55]

 

      442.460 Information about utilization and cost of health care services. In order to obtain regional or statewide data about the utilization and cost of health care services, the Oregon Health Authority may accept information relating to the utilization and cost of health care services identified by the authority from physicians, insurers or other third-party payers or employers or other purchasers of health care. [1985 c.747 §15; 1995 c.727 §31; 1997 c.683 §27; 1999 c.581 §7; 2015 c.318 §34]

 

      442.463 Annual utilization report; contents; approval; rules. (1) Each licensed health facility shall file with the Oregon Health Authority an annual report containing such information related to the facility's utilization as may be required by the authority, in such form as the authority prescribes by rule.

 

      (2) The annual report shall contain such information as may be required by rule of the authority and must be approved by the authority. [1985 c.747 §§18,19; 1995 c.727 §32; 1997 c.683 §28; 1999 c.581 §8; 2015 c.318 §35]

ORS 676.454
 
      676.454 Health care provider incentive program; rules. (1) There is created in the Oregon Health Authority a health care provider incentive program for the purpose of assisting qualified health care providers who commit to serving medical assistance and Medicare enrollees in rural or medically underserved areas of this state. The authority shall prescribe by rule:
      (a) Participant eligibility criteria, including the types of qualified health care providers who may participate in the program;
      (b) The terms and conditions of participation in the program, including the duration of the term of any service agreement, which must be at least 12 months;
      (c) The types of incentives that may be provided, including but not limited to:
      (A) Loan repayment subsidies;
      (B) Stipends;
      (C) Medical malpractice insurance premium subsidies;
      (D) Scholarships for students in health professional training programs at the Oregon Health and Science University;
      (E) Scholarships for students at institutions of higher education based in this state who are enrolled in health professional training programs leading to a doctor of osteopathic medicine or doctor of dentistry or a license as a nurse practitioner, physician assistant or certified registered nurse anesthetist, if:
      (i) The scholarship funds are distributed equitably among schools offering the training programs, based on the percentage of Oregon students attending those schools; and
      (ii) The maximum scholarship for each student does not exceed the highest resident tuition rate at the publicly funded health professional training programs in this state; and
      (F) Paying the moving expenses of providers not located in rural or medically underserved areas who commit to relocate to such areas;
      (d) If the funds allocated to the program from the Health Care Provider Incentive Fund established under ORS 676.450 are insufficient to provide assistance to all of the applicants who are eligible to participate in the program, the priority for the distribution of funds; and
      (e) The financial penalties imposed on an individual who fails to comply with terms and conditions of participation.
      (2) Eligibility requirements adopted for the program:
      (a) Must allow providers to qualify for multiple health care provider incentives, to the extent permitted by federal law.
      (b) Must allow providers to qualify for an incentive for multiyear periods.
      (c) Must give preference to applicants willing to:
      (A) Commit to extended periods of service in rural or medically underserved areas; or
      (B) Serve patients enrolled in Medicare and the state medical assistance program in at least the same proportion to the provider’s total number of patients as the Medicare and medical assistance patient populations represent in relation to the total number of persons determined by the Office of Rural Health to be in need of health care in the area served by the practice.
      (3) The authority may use funds allocated to the program from the Health Care Provider Incentive Fund to administer or provide funding to a locum tenens program for health care providers practicing in rural areas of this state.
      (4) The authority may enter into contracts with one or more public or private entities to administer the health care provider incentive program or parts of the program.
      (5) The authority shall decide no later than September 1 of each academic year the distribution of funds for scholarships that will be provided in the next academic year.
      (6) The authority may receive gifts, grants or contributions from any source, whether public or private, to carry out the provisions of this section. Moneys received under this subsection shall be deposited in the Health Care Provider Incentive Fund established under ORS 676.450. [Formerly 676.460]

676.410 Information required for renewal of certain licenses; confidentiality; data collection; fees; rules.

      (1) As used in this section, “health care workforce regulatory board” means the:

      (a) State Board of Examiners for Speech-Language Pathology and Audiology;

      (b) State Board of Chiropractic Examiners;

      (c) State Board of Licensed Social Workers;

      (d) Oregon Board of Licensed Professional Counselors and Therapists;

      (e) Oregon Board of Dentistry;

      (f) Board of Licensed Dietitians;

      (g) State Board of Massage Therapists;

      (h) Oregon Board of Naturopathic Medicine;

      (i) Oregon State Board of Nursing;

      (j) Respiratory Therapist and Polysomnographic Technologist Licensing Board;

      (k) Oregon Board of Optometry;

      (L) State Board of Pharmacy;

      (m) Oregon Medical Board;

      (n) Occupational Therapy Licensing Board;

      (o) Oregon Board of Physical Therapy;

      (p) Oregon Board of Psychology; and

      (q) Board of Medical Imaging.

      (2) An individual applying to renew a license with a health care workforce regulatory board must provide the information prescribed by the Oregon Health Authority pursuant to subsection (3) of this section to the health care workforce regulatory board. Except as provided in subsection (4) of this section, a health care workforce regulatory board may not approve an application to renew a license until the applicant provides the information.

      (3) The authority shall collaborate with each health care workforce regulatory board to adopt rules establishing:

      (a) The information that must be provided to a health care workforce regulatory board under subsection (2) of this section, which may include:

      (A) Demographics, including race and ethnicity.

      (B) Education and training information.

      (C) License information.

      (D) Employment information.

      (E) Primary and secondary practice information.

      (F) Anticipated changes in the practice.

      (G) Languages spoken.

      (b) The manner and form of providing information under subsection (2) of this section.

      (4)(a) Subject to paragraph (b) of this subsection, a health care workforce regulatory board shall report health care workforce information collected under subsection (2) of this section to the authority.

      (b) Except as provided in paragraph (c) of this subsection, personally identifiable information collected under subsection (2) of this section is confidential and a health care workforce regulatory board and the authority may not release such information.

      (c) A health care workforce regulatory board may release personally identifiable information collected under subsection (2) of this section to a law enforcement agency for investigative purposes or to the authority for state health planning purposes.

      (5) A health care workforce regulatory board may adopt rules to perform the board’s duties under this section.

      (6) In addition to renewal fees that may be imposed by a health care workforce regulatory board, the authority shall establish fees to be paid by individuals applying to renew a license with a health care workforce regulatory board. The amount of fees established under this subsection must be reasonably calculated to reimburse the actual cost of obtaining or reporting information as required by subsection (2) of this section.

      (7) Using information collected under subsection (2) of this section, the authority shall create and maintain a health care workforce database. The authority shall provide data from the health care workforce database and may provide data from other relevant sources, including data related to the diversity of this state’s health care workforce, upon request to state agencies and to the Legislative Assembly. The authority may contract with a private or public entity to establish and maintain the database and to perform data analysis. [2009 c.595 §1175; 2011 c.630 §23; 2013 c.14 §9; 2015 c.318 §40; 2015 c.380 §1; 2017 c.6 §24; 2019 c.3 §3; 2019 c.43 §8]

 

      Note: Section 3, chapter 380, Oregon Laws 2015, provides:

      Sec. 3. (1) For individuals applying to renew a license to practice a regulated profession with the Oregon Board of Dentistry, Board of Licensed Dietitians, Oregon State Board of Nursing, State Board of Pharmacy, Oregon Medical Board, Occupational Therapy Licensing Board and Physical Therapist Licensing Board, the amendments to ORS 676.410 by section 1, chapter 380, Oregon Laws 2015, apply to applications to renew a license to practice a regulated profession that are submitted on or after January 1, 2016.

      (2) For individuals applying to renew a license to practice a regulated profession with the State Board of Examiners for Speech-Language Pathology and Audiology, State Board of Chiropractic Examiners, State Board of Licensed Social Workers, Oregon Board of Licensed Professional Counselors and Therapists, State Board of Massage Therapists, Oregon Board of Naturopathic Medicine, Respiratory Therapist and Polysomnographic Technologist Licensing Board, Oregon Board of Optometry, Oregon Board of Psychology and Board of Medical Imaging, the amendments to ORS 676.410 by section 1, chapter 380, Oregon Laws 2015, apply to applications to renew a license to practice a regulated profession that are submitted on or after the date on which rules are adopted for health care workers regulated by a health care workforce regulatory board pursuant to ORS 676.410 (3). [2015 c.380 §3; 2017 c.6 §25]

ORS 414.688 to 414.704

      414.688 Commission established; membership. 
      (1) As used in this section:
      (a) “Practice of pharmacy” has the meaning given that term in ORS 689.005.
      (b) “Retail drug outlet” has the meaning given that term in ORS 689.005.
      (2) The Health Evidence Review Commission is established in the Oregon Health Authority, consisting of 13 members appointed by the Governor in consultation with professional and other interested organizations, and confirmed by the Senate, as follows:
      (a) Five members must be physicians licensed to practice medicine in this state who have clinical expertise in the areas of family medicine, internal medicine, obstetrics, perinatal health, pediatrics, disabilities, geriatrics or general surgery. One of the physicians must be a doctor of osteopathic medicine, and one must be a hospital representative or a physician whose practice is significantly hospital-based.
      (b) One member must be a dentist licensed under ORS chapter 679 who has clinical expertise in general, pediatric or public health dentistry.
      (c) One member must be a public health nurse.
      (d) One member must be a behavioral health representative who may be a social services worker, alcohol and drug treatment provider, psychologist or psychiatrist.
      (e) Two members must be consumers of health care who are patient advocates or represent the areas of indigent services, labor, business, education or corrections.
      (f) One member must be a complementary or alternative medicine provider who is a chiropractic physician licensed under ORS chapter 684, a naturopathic physician licensed under ORS chapter 685 or an acupuncturist licensed under ORS chapter 677.
      (g) One member must be an insurance industry representative who may be a medical director or other administrator.
      (h) One member must be a pharmacy representative who engages in the practice of pharmacy at a retail drug outlet.
      (3) No more than six members of the commission may be physicians either in active practice or retired from practice.
      (4) Members of the commission serve for a term of four years at the pleasure of the Governor. A member is eligible for reappointment.
      (5) Members are not entitled to compensation, but may be reimbursed for actual and necessary travel and other expenses incurred by them in the performance of their official duties in the manner and amounts provided for in ORS 292.495. Claims for expenses shall be paid out of funds available to the Oregon Health Authority for purposes of the commission. [2011 c.720 §22; 2017 c.409 §10]
 
      414.689 Members; meetings. 
      (1) The Health Evidence Review Commission shall select one of its members as chairperson and another as vice chairperson, for terms and with duties and powers the commission determines necessary for the performance of the functions of the offices.
      (2) A majority of the members of the commission constitutes a quorum for the transaction of business.
      (3) The commission shall meet at least four times per year at a place, day and hour determined by the chairperson. The commission also shall meet at other times and places specified by the call of the chairperson or of a majority of the members of the commission.
      (4) The commission may use advisory committees or subcommittees whose members are appointed by the chairperson of the commission subject to approval by a majority of the members of the commission. The advisory committees or subcommittees may contain experts appointed by the chairperson and a majority of the members of the commission. The conditions of service of the experts will be determined by the chairperson and a majority of the members of the commission.
      (5) The Oregon Health Authority shall provide staff and support services to the commission. [2011 c.720 §23; 2015 c.318 §22]
 
      414.690 Prioritized list of health services. 
      (1) The Health Evidence Review Commission shall regularly solicit testimony and information from stakeholders representing consumers, advocates, providers, carriers and employers in conducting the work of the commission.
      (2) The commission shall actively solicit public involvement through a public meeting process to guide health resource allocation decisions.
      (3) The commission shall develop and maintain a list of health services ranked by priority, from the most important to the least important, representing the comparative benefits of each service to the population to be served. The list must be submitted by the commission pursuant to subsection (5) of this section and is not subject to alteration by any other state agency.
      (4) In order to encourage effective and efficient medical evaluation and treatment, the commission:
      (a) May include clinical practice guidelines in its prioritized list of services. The commission shall actively solicit testimony and information from the medical community and the public to build a consensus on clinical practice guidelines developed by the commission.
      (b) May include statements of intent in its prioritized list of services. Statements of intent should give direction on coverage decisions where medical codes and clinical practice guidelines cannot convey the intent of the commission.
      (c) Shall consider both the clinical effectiveness and cost-effectiveness of health services, including drug therapies, in determining their relative importance using peer-reviewed medical literature as defined in ORS 743A.060.
      (5) The commission shall report the prioritized list of services to the Oregon Health Authority for budget determinations by July 1 of each even-numbered year.
      (6) The commission shall make its report during each regular session of the Legislative Assembly and shall submit a copy of its report to the Governor, the Speaker of the House of Representatives and the President of the Senate.
      (7) The commission may alter the list during the interim only as follows:
      (a) To make technical changes to correct errors and omissions;
      (b) To accommodate changes due to advancements in medical technology or new data regarding health outcomes;
      (c) To accommodate changes to clinical practice guidelines; and
      (d) To add statements of intent that clarify the prioritized list.
      (8) If a service is deleted or added during an interim and no new funding is required, the commission shall report to the Speaker of the House of Representatives and the President of the Senate. However, if a service to be added requires increased funding to avoid discontinuing another service, the commission shall report to the Emergency Board to request the funding.
      (9) The prioritized list of services remains in effect for a two-year period beginning no earlier than October 1 of each odd-numbered year. [2011 c.720 §24]
 
      414.694 Commission review of covered reproductive health services. The Health Evidence Review Commission shall review the coverage described in ORS 743A.067 (2) and, no later than November 1 of each even-numbered year, report to the interim committees of the Legislative Assembly related to health any recommended changes to the coverage described in ORS 743A.067 (2) based upon the latest clinical research. [2017 c.721 §9]
 
      Note: 414.694 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
 
      414.695 Medical technology assessment. 
      (1) As used in this section and ORS 414.698:
      (a) “Medical technology” means medical equipment and devices, medical or surgical procedures and techniques used by health care providers in delivering medical care to individuals, and the organizational or supportive systems within which medical care is delivered.
      (b) “Medical technology assessment” means evaluation of the use, clinical effectiveness and cost of a technology in comparison with its alternatives.
      (2) The Health Evidence Review Commission shall develop a medical technology assessment process. The Oregon Health Authority shall direct the commission with regard to medical technologies to be assessed and the timing of the assessments.
      (3) The commission shall appoint and work with an advisory committee whose members have the appropriate expertise to conduct a medical technology assessment.
      (4) The commission shall present its preliminary findings at a public hearing and shall solicit testimony and information from health care consumers. The commission shall give strong consideration to the recommendations of the advisory committee and public testimony in developing its assessment.
      (5) To ensure that confidentiality is maintained, identification of a patient or a person licensed to provide health services may not be included with the data submitted under this section, and the commission shall release such data only in aggregate statistical form. All findings and conclusions, interviews, reports, studies, communications and statements procured by or furnished to the commission in connection with obtaining the data necessary to perform its functions is confidential pursuant to ORS 192.338, 192.345 and 192.355. [2011 c.720 §25]
 
      Note: 414.695 to 414.701 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
 
      414.698 Comparative effectiveness of medical technologies. 
      (1) The Health Evidence Review Commission shall conduct comparative effectiveness research of medical technologies selected in accordance with ORS 414.695. The commission may conduct the research by comprehensive review of the comparative effectiveness research undertaken by recognized state, national or international entities. The commission may consider evidence relating to prescription drugs that is relevant to a medical technology assessment but may not conduct a drug class evidence review or medical technology assessment solely of a prescription drug. The commission shall disseminate the research findings to health care consumers, providers and third-party payers and to other interested stakeholders.
      (2) The commission shall develop or identify and shall disseminate evidence-based health care guidelines for use by providers, consumers and purchasers of health care in Oregon.
      (3) The Oregon Health Authority shall vigorously pursue health care purchasing strategies that adopt the research findings described in subsection (1) of this section and the evidence-based health care guidelines described in subsection (2) of this section. [2011 c.720 §26]
 
      Note: See note under 414.695.
 
      414.701 Commission may not rely solely on comparative effectiveness research. The Health Evidence Review Commission, in ranking health services or developing guidelines under ORS 414.690 or in assessing medical technologies under ORS 414.698, and the Pharmacy and Therapeutics Committee, in considering a recommendation for a drug to be included on any preferred drug list or on the Practitioner-Managed Prescription Drug Plan, may not rely solely on the results of comparative effectiveness research. [2011 c.720 §26a]
 
      Note: See note under 414.695.
 
      414.704 Advisory committee. The Health Evidence Review Commission shall consult with an advisory committee in determining priorities for mental health care and chemical dependency. The advisory committee shall include mental health and chemical dependency professionals who provide inpatient and outpatient mental health and chemical dependency care. [Formerly 414.730]

​ORS 413.300 to 413.310

     413.300 Definitions.
     As used in ORS 413.300 (Definitions for ORS 413.300 to 413.308, 413.310 and ORS chapter 414) to 413.308 (Duties of council), 413.310 (Oregon Health Information Technology program) and ORS chapter 414:
     (1) “Electronic health record” means an electronic record of an individual’s health-related information that conforms to nationally recognized interoperability standards and that can be created, managed and consulted by authorized health care providers and staff.
     (2) “Health care provider” or “provider” means a person who is licensed, certified or otherwise authorized by law in this state to administer health care in the ordinary course of business or in the practice of a health care profession.
     (3) “Health informatics” means the interdisciplinary study of the design, development, adoption and application of information technology based innovations in health care services delivery, management and planning.
     (4) “Health information technology” means an information processing application using computer hardware and software for the storage, retrieval, sharing and use of health care information, data and knowledge for communication, decision-making, quality, safety and efficiency of a clinical practice. “Health information technology” includes, but is not limited to:
     (a) An electronic health record.
     (b) An electronic order from a health care provider for diagnosis, treatment or prescription drugs.
     (c) An electronic clinical decision support system that links health observations with health knowledge to assist health care providers in making choices for improved health care, for example by providing electronic alerts or reminders.
     (d) Tools for the collection, analysis and reporting of information or data on adverse events, the quality and efficiency of care, patient satisfaction and other health care related performance measures.
     (5) “Interoperability” means the capacity of different health information technology systems and software applications to communicate and exchange data and to make use of the data that has been exchanged. [2009 c.595 §1167; 2015 c.243 §3]

     413.301 Health Information Technology Oversight Council.
     (1) There is established a Health Information Technology Oversight Council within the Oregon Health Authority. The Oregon Health Policy Board shall:
     (a) Determine the terms of members on the council and the ​organization of the council.
     (b) Appoint members to the council who, collectively, have expertise, knowledge or direct experience in health care delivery, health information technology, health informatics and health care quality improvement.
     (c) Ensure that there is broad representation on the council of individuals and organizations that will be impacted by the Oregon Health Information Technology program.
     (2) To aid and advise the council in the performance of its functions, the council may establish such advisory and technical committees as the council considers necessary. The committees may be continuing or temporary. The council shall determine the representation, membership, terms and organization of the committees and shall appoint persons to serve on the committees.
     (3) Members of the council are not entitled to compensation, but in the discretion of the board may be reimbursed from funds available to the board for actual and necessary travel and other expenses incurred by the members of the council in the performance of their official duties in the manner and amount provided in ORS 292.495 (Compensation and expenses of members of state boards and commissions). [2009 c.595 §1168; 2015 c.243 §4]

     413.303 Council chairperson.
     (1) The Health Information Technology Oversight Council shall select one of the council’s members as chairperson, for such term and with such duties and powers necessary for the performance of the functions of the chairperson as the Oregon Health Policy Board determines.
     (2) A majority of the members of the council constitutes a quorum for the transaction of business.
     (3) The council shall meet at least quarterly at a place, day and hour determined by the council. The council may also meet at other times and places specified by the call of the chairperson or of a majority of the members of the council. [2009 c.595 §1172; 2015 c.243 §5]

     413.308 Duties of council. The duties of the Health Information Technology Oversight Council are to:
     (1) Identify and make specific recommendations related to health information technology to the Oregon Health Policy Board to achieve the goals of the Oregon Integrated and Coordinated Health Care Delivery System established by ORS 414.570 (System established).
     (2) Regularly review and report to the board on the Oregon Health Authority’s health information technology efforts, including the Oregon Health Information Technology program, toward achieving the goals of the Oregon Integrated and Coordinated Health Care Delivery System.
     ​(3) Regularly review and report to the board on the efforts of local, regional and statewide organizations to participate in health information technology systems.
     (4) Regularly review and report to the board on this state’s progress in the adoption and use of health information technology by health care providers, health systems, patients and other users.
     (5) Advise the board or the Oregon Congressional Delegation on changes to federal laws affecting health information technology that will promote this state’s efforts in utilizing health information technology. [2009 c.595 §1171; 2015 c.243 §6]

     413.310 Oregon Health Information Technology program.
     (1) The Oregon Health Authority shall establish and maintain the Oregon Health Information Technology program to:
     (a) Support the Oregon Integrated and Coordinated Health Care Delivery System established by ORS 414.570 (System established);
     (b) Facilitate the exchange and sharing of electronic health-related information;
     (c) Support improved health outcomes in this state;
     (d) Promote accountability and transparency; and
     (e) Support new payment models for coordinated care organizations and health systems.
     (2) The authority may engage in activities necessary to become accredited or certified as a provider of health information technology and take actions associated with providing health information technology.
     (3) Subject to ORS 279A.050 (Procurement authority) (7), the authority may enter into agreements with other entities that provide health information technology to carry out the objectives of the Oregon Health Information Technology program.
     (4) The authority may establish and enforce standards for connecting to and using the Oregon Health Information Technology program, including standards for interoperability, privacy and security.
     (5) The authority may conduct or participate in activities to enable and promote the secure transmission of electronic health information between users of different health information technology systems, including activities in other states. The activities may include, but are not limited to, participating in organizations or associations that manage and enforce agreements to abide by a common set of standards, policies and practices applicable to health information technology systems.
     (6) The authority may, by rule, impose fees on entities or individuals that use the program’s services in order to pay the cost of administering the Oregon Health Information Technology program.
     (7) The authority may initiate one or more partnerships or participate in new or existing collaboratives to establish and carry out the Oregon Health Information Technology program’s objectives. The authority’s participation may include, but is not limited to:
     (a) Participating as a voting member in the governing body of a partnership or collaborative that provides health information technology services;
     (b) Paying dues or providing funding to partnerships or collaboratives;
     (c) Entering into agreements, subject to ORS 279A.050 (Procurement authority) (7), with partnerships or collaboratives with respect to participation and funding in order to establish the role of the authority and protect the interests of this state when the partnerships or collaboratives provide health information technology services; or
     (d) Transferring the implementation or management of one or more services offered by the Oregon Health Information Technology program to a partnership or collaborative.
     (8) At least once each calendar year the authority shall report to the Legislative Assembly, in the manner provided in ORS 192.245 (Form of report to legislature), on the status of the Oregon Health Information Technology program. [2015 c.243 §1]
Note: 413.310 (Oregon Health Information Technology program) was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 413 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.


 ORS 414.211 to 414.227
 
     414.211 Medicaid Advisory Committee. 
      ​(1) There is established a Medicaid Advisory Committee consisting of not more than 15 members appointed by the Governor.
      (2) The committee shall be composed of:
      (a) A physician licensed under ORS chapter 677;
      (b) Two members of health care consumer groups that include Medicaid recipients;
      (c) Two Medicaid recipients, one of whom shall be a person with a disability;
      (d) The Director of the Oregon Health Authority or designee;
      (e) The Director of Human Services or designee;
      (f) Health care providers;
      (g) Persons associated with health care organizations, including but not limited to coordinated care organizations under contract to the Medicaid program; and
      (h) Members of the general public.
      (3) In making appointments, the Governor shall consult with appropriate professional and other interested organizations. All members appointed to the committee shall be familiar with the medical needs of low income persons.
      (4) The term of office for each member shall be two years, but each member shall serve at the pleasure of the Governor.
      (5) Members of the committee shall receive no compensation for their services but, subject to any applicable state law, shall be allowed actual and necessary travel expenses incurred in the performance of their duties from the Oregon Health Authority Fund. [1995 c.727 §43; 2007 c.70 §192; 2009 c.595 §287; 2011 c.602 §37; 2011 c.720 §132]
 
      Note: 414.211 and 414.221 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
 
      414.215 [1967 c.502 §19; 1991 c.66 §21; repealed by 1995 c.727 §48]
 
      414.220 [1957 c.692 §2; repealed by 1963 c.631 §2]
 
      414.221 Duties of committee. The Medicaid Advisory Committee shall advise the Director of the Oregon Health Authority and the Director of Human Services on:
      (1) Medical care, including mental health and alcohol and drug treatment and remedial care to be provided under ORS chapter 414; and
      (2) The operation and administration of programs provided under ORS chapter 414. [1995 c.727 §44; 2003 c.784 §7; 2007 c.697 §16; 2009 c.595 §288; 2011 c.720 §133]
 
      414.225 Oregon Health Authority to consult with committee. The Oregon Health Authority shall consult with the Medicaid Advisory Committee concerning the determinations required under ORS 414.065. [1967 c.502 §20; 1991 c.66 §22; 1995 c.727 §46; 2003 c.784 §8; 2009 c.595 §289]
 
      414.227 Application of public meetings law to advisory committees. 
      ​(1) ORS 192.610 to 192.690 apply to any meeting of an advisory committee with the authority to make decisions for, conduct policy research for or make recommendations to the Oregon Health Authority, the Oregon Health Policy Board or the Department of Human Services on administration or policy related to the medical assistance program operated under this chapter.
      (2) Subsection (1) of this section applies only to advisory committee meetings attended by two or more advisory committee members who are not employed by a public body. [2001 c.353 §2; 2009 c.595 §290; 2011 c.720 §134]
 

​ORS 413.006-413.017


ORS 413.006 Establishment of Oregon Health Policy Board (1) There is established the Oregon Health Policy Board, consisting of nine members appointed by the Governor.
     (2) The term of office of each member is four years, but a member serves at the pleasure of the Governor. Before the expiration of the term of a member, the Governor shall appoint a successor whose term begins on January 1 next following. A member is eligible for reappointment. If there is a vacancy for any cause, the Governor shall make an appointment to become immediately effective for the unexpired term.
     (3) The appointment of the board is subject to confirmation by the Senate in the manner prescribed in ORS 171.562 (Procedures for confirmation) and 171.565 (Vote required for confirmation).
     (4) Members of the board are entitled to reimbursement of per diem and travel expenses for their attendance at board meetings and subcommittee meetings as provided in ORS 292.495 (Compensation and expenses of members of state boards and commissions). [2009 c.595 §1]
 
ORS 413.007 Composition of board (1) The Oregon Health Policy Board consists of individuals who:
     (a) Are United States citizens and residents of this state;
     (b) Have demonstrated leadership skills in their professional and civic lives;
     (c) To the greatest extent practicable, represent the various geographic, ethnic, gender, racial and economic diversity of this state; and
     (d) Collectively offer expertise, knowledge and experience in consumer advocacy, management of a company that offers health insurance to its employees, public health, finance, organized labor, health care and the operation of a small business.
     (2) No more than four members of the board may be individuals:
     (a) Whose household incomes, during the individuals’ tenure on the board or during the 12-month period prior to the individuals’ appointment to the board, come from health care or from a health care related field; or
     (b) Who receive health care benefits from a publicly funded state health benefit plan.
     (3) No more than four members of the board may be, during the individuals’ tenure on the board or during the 12-month period prior to the individuals’ appointment to the board, employed in a health care or health care related field.
     (4) At least one member of the board shall have an active license to provide health care in Oregon and shall be appointed to serve in addition to the members offering the expertise, knowledge and experience described in subsection (1)(d) of this section. [2009 c.595 §4]
 
ORS 413.008 Chairperson (1) The Governor shall select from the membership of the Oregon Health Policy Board the chairperson and vice chairperson.
     (2) A majority of the members of the board constitutes a quorum for the transaction of business.
     (3) The board shall meet at least once every month and shall meet at least once every two years in each congressional district in this state, at a place, day and hour determined by the board. The board may also meet at other times and places specified by the call of the chairperson or a majority of the members of the board, or as specified in bylaws adopted by the board. [2009 c.595 §5]
 
ORS 413.011 Duties of board (1) The duties of the Oregon Health Policy Board are to:
     (a) Be the policy-making and oversight body for the Oregon Health Authority established in ORS 413.032 (Establishment of Oregon Health Authority) and all of the authority’s departmental divisions.
     (b) Develop and submit a plan to the Legislative Assembly by December 31, 2010, to provide and fund access to affordable, quality health care for all Oregonians by 2015.
     (c) Develop a program to provide health insurance premium assistance to all low and moderate income individuals who are legal residents of Oregon.
     (d) Publish health outcome and quality measure data collected by the Oregon Health Authority at aggregate levels that do not disclose information otherwise protected by law. The information published must report, for each coordinated care organization and each health benefit plan sold through the health insurance exchange or offered by the Oregon Educators Benefit Board or the Public Employees’ Benefit Board:
     (A) Quality measures;
     (B) Costs;
     (C) Health outcomes; and
     (D) Other information that is necessary for members of the public to evaluate the value of health services delivered by each coordinated care organization and by each health benefit plan.
     (e) Establish evidence-based clinical standards and practice guidelines that may be used by providers.
     (f) Approve and monitor community-centered health initiatives described in ORS 413.032 (Establishment of Oregon Health Authority) (1)(h) that are consistent with public health goals, strategies, programs and performance standards adopted by the Oregon Health Policy Board to improve the health of all Oregonians, and shall regularly report to the Legislative Assembly on the accomplishments and needed changes to the initiatives.
     (g) Establish cost containment mechanisms to reduce health care costs.
     (h) Ensure that Oregon’s health care workforce is sufficient in numbers and training to meet the demand that will be created by the expansion in health coverage, health care system transformations, an increasingly diverse population and an aging workforce.
     (i) Work with the Oregon congressional delegation to advance the adoption of changes in federal law or policy to promote Oregon’s comprehensive health reform plan.
     (j) Establish a health benefit package in accordance with ORS 741.340 (Health benefit plans offered through exchange) to be used as the baseline for all health benefit plans offered through the health insurance exchange.
     (k) Investigate and report annually to the Legislative Assembly on the feasibility and advisability of future changes to the health insurance market in Oregon, including but not limited to the following:
     (A) A requirement for every resident to have health insurance coverage.
     (B) A payroll tax as a means to encourage employers to continue providing health insurance to their employees.
     (L) Meet cost-containment goals by structuring reimbursement rates to reward comprehensive management of diseases, quality outcomes and the efficient use of resources by promoting cost-effective procedures, services and programs including, without limitation, preventive health, dental and primary care services, web-based office visits, telephone consultations and telemedicine consultations.
     (m) Oversee the expenditure of moneys from the Health Care Workforce Strategic Fund to support grants to primary care providers and rural health practitioners, to increase the number of primary care educators and to support efforts to create and develop career ladder opportunities.
     (n) Work with the Public Health Benefit Purchasers Committee, administrators of the medical assistance program and the Department of Corrections to identify uniform contracting standards for health benefit plans that achieve maximum quality and cost outcomes and align the contracting standards for all state programs to the greatest extent practicable.
     (o) Work with the Health Information Technology Oversight Council to foster health information technology systems and practices that promote the Oregon Integrated and Coordinated Health Care Delivery System established by ORS 414.570 (System established) and align health information technology systems and practices across this state.
     (2) The Oregon Health Policy Board is authorized to:
     (a) Subject to the approval of the Governor, organize and reorganize the authority as the board considers necessary to properly conduct the work of the authority.
     (b) Submit directly to the Legislative Counsel, no later than October 1 of each even-numbered year, requests for measures necessary to provide statutory authorization to carry out any of the board’s duties or to implement any of the board’s recommendations. The measures may be filed prior to the beginning of the legislative session in accordance with the rules of the House of Representatives and the Senate.
     (3) If the board or the authority is unable to perform, in whole or in part, any of the duties described in ORS 413.006 (Establishment of Oregon Health Policy Board) to 413.042 (Rules) and 741.340 (Health benefit plans offered through exchange) without federal approval, the authority is authorized to request, in accordance with ORS 413.072 (Public process required if waiver of federal requirement involves policy change), waivers or other approval necessary to perform those duties. The authority shall implement any portions of those duties not requiring legislative authority or federal approval, to the extent practicable.
     (4) The enumeration of duties, functions and powers in this section is not intended to be exclusive nor to limit the duties, functions and powers imposed on the board by ORS 413.006 (Establishment of Oregon Health Policy Board) to 413.042 (Rules) and 741.340 (Health benefit plans offered through exchange) and by other statutes.
     (5) The board shall consult with the Department of Consumer and Business Services in completing the tasks set forth in subsection (1)(j) and (k)(A) of this section. [2009 c.595 §9; 2011 c.9 §55; 2011 c.720 §125; 2012 c.38 §15; 2013 c.1 §55; 2013 c.681 §44; 2015 c.3 §42; 2015 c.243 §2; 2015 c.389 §6]
 
ORS 413.014 Rules
In accordance with applicable provisions of ORS chapter 183, the Oregon Health Policy Board may adopt rules necessary for the administration of the laws that the board is charged with administering. [2009 c.595 §6]

ORS 413.016 Authority of board to establish advisory and technical committees (1) The Oregon Health Policy Board may establish such advisory and technical committees as the board considers necessary to aid and advise the board in the performance of the board’s functions. These committees may be continuing or temporary committees. The board shall determine the representation, membership, terms and organization of the committees and shall appoint the members of the committees.
     (2) Members of the committees who are not members of the board are not entitled to compensation, but at the discretion of the board may be reimbursed from funds available to the board for actual and necessary travel and other expenses incurred by them in the performance of their official duties, in the manner and amount provided in ORS 292.495 (Compensation and expenses of members of state boards and commissions). [2009 c.595 §8]
 
ORS 413.017 Public Health Benefit Purchasers Committee, Health Care Workforce Committee and Health Plan Quality Metrics Committee (1) The Oregon Health Policy Board shall establish the committees described in subsections (2) to (4) of this section.
     (2)(a) The Public Health Benefit Purchasers Committee shall include individuals who purchase health care for the following:
     (A) The Public Employees’ Benefit Board.
     (B) The Oregon Educators Benefit Board.
     (C) Trustees of the Public Employees Retirement System.
     (D) A city government.
     (E) A county government.
     (F) A special district.
     (G) Any private nonprofit organization that receives the majority of its funding from the state and requests to participate on the committee.
     (b) The Public Health Benefit Purchasers Committee shall:
     (A) Identify and make specific recommendations to achieve uniformity across all public health benefit plan designs based on the best available clinical evidence, recognized best practices for health promotion and disease management, demonstrated cost-effectiveness and shared demographics among the enrollees within the pools covered by the benefit plans.
     (B) Develop an action plan for ongoing collaboration to implement the benefit design alignment described in subparagraph (A) of this paragraph and shall leverage purchasing to achieve benefit uniformity if practicable.
     (C) Continuously review and report to the Oregon Health Policy Board on the committee’s progress in aligning benefits while minimizing the cost shift to individual purchasers of insurance without shifting costs to the private sector or the health insurance exchange.
     (c) The Oregon Health Policy Board shall work with the Public Health Benefit Purchasers Committee to identify uniform provisions for state and local public contracts for health benefit plans that achieve maximum quality and cost outcomes. The board shall collaborate with the committee to develop steps to implement joint contract provisions. The committee shall identify a schedule for the implementation of contract changes. The process for implementation of joint contract provisions must include a review process to protect against unintended cost shifts to enrollees or agencies.
     (3) (a) The Health Care Workforce Committee shall include individuals who have the collective expertise, knowledge and experience in a broad range of health professions, health care education and health care workforce development initiatives.
     (b) The Health Care Workforce Committee shall coordinate efforts to recruit and educate health care professionals and retain a quality workforce to meet the demand that will be created by the expansion in health care coverage, system transformations and an increasingly diverse population.
     (c) The Health Care Workforce Committee shall conduct an inventory of all grants and other state resources available for addressing the need to expand the health care workforce to meet the needs of Oregonians for health care.
     (4) (a) The Health Plan Quality Metrics Committee shall include the following members appointed by the Oregon Health Policy Board:
     (A) An individual representing the Oregon Health Authority;
     (B) An individual representing the Oregon Educators Benefit Board;
     (C) An individual representing the Public Employees’ Benefit Board;
     (D) An individual representing the Department of Consumer and Business Services;
     (E) Two health care providers;
     (F) One individual representing hospitals;
     (G) One individual representing insurers, large employers or multiple employer welfare arrangements;
     (H) Two individuals representing health care consumers;
     (I) Two individuals representing coordinated care organizations;
     (J) One individual with expertise in health care research;
     (K) One individual with expertise in health care quality measures; and
     (L) One individual with expertise in mental health and addiction services.
     (b) The committee shall work collaboratively with the Oregon Educators Benefit Board, the Public Employees’ Benefit Board, the authority and the department to adopt health outcome and quality measures that are focused on specific goals and provide value to the state, employers, insurers, health care providers and consumers. The committee shall be the single body to align health outcome and quality measures used in this state with the requirements of health care data reporting to ensure that the measures and requirements are coordinated, evidence-based and focused on a long term statewide vision.
     (c) The committee shall use a public process that includes an opportunity for public comment to identify health outcome and quality measures that may be applied to services provided by coordinated care organizations or paid for by health benefit plans sold through the health insurance exchange or offered by the Oregon Educators Benefit Board or the Public Employees’ Benefit Board. The authority, the department, the Oregon Educators Benefit Board and the Public Employees’ Benefit Board are not required to adopt all of the health outcome and quality measures identified by the committee but may not adopt any health outcome and quality measures that are different from the measures identified by the committee. The measures must take into account the recommendations of the metrics and scoring subcommittee created in ORS 414.638 (Metrics and scoring subcommittee) and the differences in the populations served by coordinated care organizations and by commercial insurers.
     (d) In identifying health outcome and quality measures, the committee shall prioritize measures that:
     (A) Utilize existing state and national health outcome and quality measures, including measures adopted by the Centers for Medicare and Medicaid Services, that have been adopted or endorsed by other state or national organizations and have a relevant state or national benchmark;
     (B) Given the context in which each measure is applied, are not prone to random variations based on the size of the denominator;
     (C) Utilize existing data systems, to the extent practicable, for reporting the measures to minimize redundant reporting and undue burden on the state, health benefit plans and health care providers;
     (D) Can be meaningfully adopted for a minimum of three years;
     (E) Use a common format in the collection of the data and facilitate the public reporting of the data; and
     (F) Can be reported in a timely manner and without significant delay so that the most current and actionable data is available.
     (e) The committee shall evaluate on a regular and ongoing basis the health outcome and quality measures adopted under this section.
     (f) The committee may convene subcommittees to focus on gaining expertise in particular areas such as data collection, health care research and mental health and substance use disorders in order to aid the committee in the development of health outcome and quality measures. A subcommittee may include stakeholders and staff from the authority, the Department of Human Services, the Department of Consumer and Business Services, the Early Learning Council or any other agency staff with the appropriate expertise in the issues addressed by the subcommittee.
     (g) This subsection does not prevent the authority, the Department of Consumer and Business Services, commercial insurers, the Public Employees’ Benefit Board or the Oregon Educators Benefit Board from establishing programs that provide financial incentives to providers for meeting specific health outcome and quality measures adopted by the committee.
     (5) Members of the committees described in subsections (2) to (4) of this section who are not members of the Oregon Health Policy Board are not entitled to compensation but shall be reimbursed from funds available to the board for actual and necessary travel and other expenses incurred by them by their attendance at committee meetings, in the manner and amount provided in ORS 292.495 (Compensation and expenses of members of state boards and commissions). [2009 c.595 §7; 2015 c.3 §43; 2015 c.389 §2; 2019 c.3 §1]

​ORS 414.312 to 414.320

      414.312 Oregon Prescription Drug Program. (1) As used in ORS 414.312 to 414.318:

      (a) "Pharmacy benefit manager" means an entity that negotiates and executes contracts with pharmacies, manages preferred drug lists, negotiates rebates with prescription drug manufacturers and serves as an intermediary between the Oregon Prescription Drug Program, prescription drug manufacturers and pharmacies.

      (b) "Prescription drug claims processor" means an entity that processes and pays prescription drug claims, adjudicates pharmacy claims, transmits prescription drug prices and claims data between pharmacies and the Oregon Prescription Drug Program and processes related payments to pharmacies.

      (c) "Program price" means the reimbursement rates and prescription drug prices established by the administrator of the Oregon Prescription Drug Program.

      (2) The Oregon Prescription Drug Program is established in the Oregon Health Authority. The purpose of the program is to:

      (a) Purchase prescription drugs, replenish prescription drugs dispensed or reimburse pharmacies for prescription drugs in order to receive discounted prices and rebates;

      (b) Make prescription drugs available at the lowest possible cost to participants in the program as a means to promote health;

      (c) Maintain a list of prescription drugs recommended as the most effective prescription drugs available at the best possible prices; and

      (d) Promote health through the purchase and provision of discount prescription drugs and coordination of comprehensive prescription benefit services for eligible entities and members.

      (3) The Director of the Oregon Health Authority shall appoint an administrator of the Oregon Prescription Drug Program. The administrator may:

      (a) Negotiate price discounts and rebates on prescription drugs with prescription drug manufacturers or group purchasing organizations;

      (b) Purchase prescription drugs on behalf of individuals and entities that participate in the program;

      (c) Contract with a prescription drug claims processor to adjudicate pharmacy claims and transmit program prices to pharmacies;

      (d) Determine program prices and reimburse or replenish pharmacies for prescription drugs dispensed or transferred;

      (e) Adopt and implement a preferred drug list for the program;

      (f) Develop a system for allocating and distributing the operational costs of the program and any rebates obtained to participants of the program; and

      (g) Cooperate with other states or regional consortia in the bulk purchase of prescription drugs.

      (4) The following individuals or entities may participate in the program:

      (a) Public Employees' Benefit Board, Oregon Educators Benefit Board and Public Employees Retirement System;

      (b) Local governments as defined in ORS 174.116 and special government bodies as defined in ORS 174.117 that directly or indirectly purchase prescription drugs;

      (c) Oregon Health and Science University established under ORS 353.020;

      (d) State agencies that directly or indirectly purchase prescription drugs, including agencies that dispense prescription drugs directly to persons in state-operated facilities;

      (e) Residents of this state who lack or are underinsured for prescription drug coverage;

      (f) Private entities; and

      (g) Labor organizations.

      (5) The administrator may establish different program prices for pharmacies in rural areas to maintain statewide access to the program.

      (6) The administrator may establish the terms and conditions for a pharmacy to enroll in the program. A licensed pharmacy that is willing to accept the terms and conditions established by the administrator may apply to enroll in the program.

      (7) Except as provided in subsection (8) of this section, the administrator may not:

      (a) Contract with a pharmacy benefit manager;

      (b) Establish a state-managed wholesale or retail drug distribution or dispensing system; or

      (c) Require pharmacies to maintain or allocate separate inventories for prescription drugs dispensed through the program.

      (8) The administrator shall contract with one or more entities to perform any of the functions of the program, including but not limited to:

      (a) Contracting with a pharmacy benefit manager and directly or indirectly with such pharmacy networks as the administrator considers necessary to maintain statewide access to the program.

      (b) Negotiating with prescription drug manufacturers on behalf of the administrator.

      (9) Notwithstanding subsection (4)(e) of this section, individuals who are eligible for Medicare Part D prescription drug coverage may participate in the program.

      (10) The program may contract with vendors as necessary to utilize discount purchasing programs, including but not limited to group purchasing organizations established to meet the criteria of the Nonprofit Institutions Act, 15 U.S.C. 13c, or that are exempt under the Robinson-Patman Act, 15 U.S.C. 13. [2003 c.714 §1; 2007 c.2 §1; 2007 c.67 §1; 2007 c.697 §17; 2009 c.263 §2; 2009 c.466 §1; 2009 c.595 §291; 2011 c.720 §136; 2013 c.14 §6; 2015 c.551 §1]

 

      Note: 414.312 to 414.320 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.


      414.314 Application and participation in Oregon Prescription Drug Program; prescription drug charges; fees. (1) An individual or entity described in ORS 414.312 (4) may apply to participate in the Oregon Prescription Drug Program. Participants shall apply on an application provided by the Oregon Health Authority. The authority may charge participants a nominal fee to participate in the program. The authority shall issue a prescription drug identification card to participants of the program.

      (2) The authority shall provide a mechanism to calculate and transmit the program prices for prescription drugs to a pharmacy. The pharmacy shall charge the participant the program price for a prescription drug.

      (3) A pharmacy may charge the participant the professional dispensing fee set by the authority.

      (4) Prescription drug identification cards issued under this section must contain the information necessary for proper claims adjudication or transmission of price data. [2003 c.714 §2; 2007 c.67 §2; 2007 c.697 §18; 2009 c.595 §292]

      Note: See note under 414.312.

      414.316 [2003 c.714 §3; 2007 c.697 §19; 2009 c.595 §293; repealed by 2015 c.318 §56]

      414.318 Prescription Drug Purchasing Fund. The Prescription Drug Purchasing Fund is established separate and distinct from the General Fund. The Prescription Drug Purchasing Fund shall consist of moneys appropriated to the fund by the Legislative Assembly and moneys received by the Oregon Health Authority for the purposes established in this section in the form of gifts, grants, bequests, endowments or donations. The moneys in the Prescription Drug Purchasing Fund are continuously appropriated to the authority and shall be used to purchase prescription drugs, reimburse pharmacies for prescription drugs and reimburse the authority for the costs of administering the Oregon Prescription Drug Program, including contracted services costs, computer costs, professional dispensing fees paid to retail pharmacies and other reasonable program costs. Interest earned on the fund shall be credited to the fund. [2003 c.714 §4; 2007 c.697 §20; 2009 c.595 §294]

      Note: See note under 414.312.

      414.320 Rules. The Oregon Health Authority shall adopt rules to implement and administer ORS 414.312 to 414.318. The rules shall include but are not limited to establishing procedures for:

      (1) Issuing prescription drug identification cards to individuals and entities that participate in the Oregon Prescription Drug Program; and

      (2) Enrolling pharmacies in the program. [2003 c.714 §5; 2007 c.697 §21; 2009 c.595 §295]

      Note: See note under 414.312.

ORS 413.570 to 413.599


     413.570 Pain Management Commission; duties; staffing. (1) The Pain Management Commission is established within the Oregon Health Authority. The commission shall:
      (a) Develop pain management recommendations;
      (b) Develop ways to improve pain management services through research, policy analysis and model projects; and
      (c) Represent the concerns of patients in Oregon on issues of pain management to the Governor and the Legislative Assembly.
      (2) The pain management coordinator of the authority shall serve as staff to the commission. [Formerly 409.500]​

      Note: 413.570 to 413.599 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 413 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.​

      413.572 Additional duties of commission. (1) The Pain Management Commission shall:
      (a) Develop a pain management education program curriculum for a one-hour training and update it biennially.
      (b) Provide health professional regulatory boards and other health boards, committees or task forces with the curriculum.
      (c) Work with health professional regulatory boards and other health boards, committees or task forces to develop approved pain management education programs as required.
      (2) The curriculum must take into account the needs of Oregon Tribal communities, communities of color and other groups who have been disproportionately affected by adverse social determinants of health, such as racism, trauma, adverse childhood experiences and other factors that influence how an individual experiences chronic pain. [Formerly 409.510; 2021 c.50 §2] 

      Note: See note under 413.570. 

      413.574 Membership of commission. (1) The Pain Management Commission shall consist of 19 members as follows:
      (a) Seventeen members shall be appointed by the Director of the Oregon Health Authority. Prior to making appointments, the director shall request and consider recommendations from individuals and public and private agencies and organizations with experience or a demonstrated interest in pain management issues, including but not limited to:
      (A) Physicians licensed under ORS chapter 677 or organizations representing physicians;
      (B) Nurses licensed under ORS chapter 678 or organizations representing nurses;
      (C) Psychologists licensed under ORS 675.010 to 675.150 or organizations representing psychologists;
      (D) Physician assistants licensed under ORS chapter 677 or organizations representing physician assistants;
      (E) Chiropractic physicians licensed under ORS chapter 684 or organizations representing chiropractic physicians;
      (F) Naturopaths licensed under ORS chapter 685 or organizations representing naturopaths;
      (G) Clinical social workers licensed under ORS 675.530 or organizations representing clinical social workers;
      (H) Acupuncturists licensed under ORS 677.759;
      (I) Pharmacists licensed under ORS chapter 689;
      (J) Palliative care professionals or organizations representing palliative care professionals;
      (K) Mental health professionals or organizations representing mental health professionals;
      (L) Health care consumers or organizations representing health care consumers;
      (M) Hospitals and health plans or organizations representing hospitals and health plans;
      (N) Patients or advocacy groups representing patients;
      (O) Dentists licensed under ORS chapter 679;
      (P) Occupational therapists licensed under ORS 675.210 to 675.340;
      (Q) Physical therapists licensed under ORS 688.010 to 688.201; and
      (R) Members of the public.
      (b) Two members shall be members of a legislative committee with jurisdiction over human services issues, one appointed by the President of the Senate and one appointed by the Speaker of the House of Representatives. Both members shall be nonvoting members of the commission.
      (2) The term of office of each member is four years, but a member serves at the pleasure of the appointing authority. Before the expiration of the term of a member, the appointing authority shall appoint a successor whose term begins on July 1 next following. A member is eligible for reappointment. If there is a vacancy for any cause, the appointing authority shall make an appointment to become immediately effective for the unexpired term.
​      (3) Members of the commission are not entitled to compensation or reimbursement for expenses and serve as volunteers on the commission. [Formerly 409.520; 2019 c.13 §42] 

      Note: See note under 413.570.​

      413.576 Selection of chairperson and vice chairperson; requirements for commission meetings. (1) The Director of the Oregon Health Authority shall select one member of the Pain Management Commission as chairperson and another as vice chairperson, for such terms and with duties and powers necessary for the performance of the functions of such offices as the director determines.
      (2) A majority of the voting members of the commission constitutes a quorum for the transaction of business.
      (3) The commission shall meet at least once every six months at a place, day and hour determined by the director. The commission also shall meet at other times and places specified by the call of the chairperson or of a majority of the members of the commission. [Formerly 409.530] 

      Note: See note under 413.570. 

      413.580 Pain Management Fund. There is established the Pain Management Fund in the Oregon Health Authority Fund established under ORS 413.101. All moneys credited to the Pain Management Fund are continuously appropriated for the purposes of ORS 413.570 to 413.599 to be expended by the Pain Management Commission established under ORS 413.570. [Formerly 409.540] 

      Note: See note under 413.570. 

      413.582 Acceptance of contributions. The Pain Management Commission may accept contributions of funds and assistance from the United States Government or its agencies or from any other source, public or private, and agree to conditions thereon not inconsistent with the purposes of the commission. All such funds shall be deposited in the Pain Management Fund established in ORS 413.580 to aid in financing the duties, functions and powers of the commission. [Formerly 409.550] 

      Note: See note under 413.570. 

      413.590 Pain management education required of certain licensed health care professionals; duties of Oregon Medical Board; rules. (1) The following practitioners must complete a pain management education program described in ORS 413.572 (1)(c) or an equivalent pain management education program as described in ORS 675.110, 677.228, 677.510, 678.101, 684.092, 685.102 or 689.285 at initial licensure and every 36 months thereafter:
      (a) A physician assistant licensed under ORS chapter 677;
      (b) A nurse licensed under ORS chapter 678;
      (c) A psychologist licensed under ORS 675.010 to 675.150;
      (d) A chiropractic physician licensed under ORS chapter 684;
      (e) A naturopath licensed under ORS chapter 685;
      (f) An acupuncturist licensed under ORS 677.759;
      (g) A pharmacist licensed under ORS chapter 689;
      (h) A dentist licensed under ORS chapter 679;
      (i) An occupational therapist licensed under ORS 675.210 to 675.340;
      (j) A physical therapist licensed under ORS 688.010 to 688.201; and
      (k) An optometrist licensed under ORS chapter 683.
      (2) The Oregon Medical Board, in consultation with the Pain Management Commission, shall identify by rule physicians licensed under ORS chapter 677 who, on an ongoing basis, treat patients in chronic or terminal pain and who must complete a pain management education program described in ORS 413.572. The board may identify by rule circumstances under which a requirement under this section may be waived. [Formerly 409.560; 2019 c.3 §2; 2021 c.50 §3] 

      Note: The amendments to 413.590 by section 15, chapter 349, Oregon Laws 2021, become operative July 15, 2022. See section 21, chapter 349, Oregon Laws 2021. The text that is operative on and after July 15, 2022, is set forth for the user’s convenience.

      413.590. (1) The following practitioners must complete a pain management education program described in ORS 413.572 (1)(c) or an equivalent pain management education program as described in ORS 675.110, 677.228, 678.101, 684.092, 685.102 or 689.285 at initial licensure and every 36 months thereafter:
      (a) A physician assistant licensed under ORS chapter 677;
      (b) A nurse licensed under ORS chapter 678;
      (c) A psychologist licensed under ORS 675.010 to 675.150;
      (d) A chiropractic physician licensed under ORS chapter 684;
      (e) A naturopath licensed under ORS chapter 685;
      (f) An acupuncturist licensed under ORS 677.759;
      (g) A pharmacist licensed under ORS chapter 689;
      (h) A dentist licensed under ORS chapter 679;
      (i) An occupational therapist licensed under ORS 675.210 to 675.340;
      (j) A physical therapist licensed under ORS 688.010 to 688.201; and
      (k) An optometrist licensed under ORS chapter 683.
      (2) The Oregon Medical Board, in consultation with the Pain Management Commission, shall identify by rule physicians licensed under ORS chapter 677 who, on an ongoing basis, treat patients in chronic or terminal pain and who must complete a pain management education program described in ORS 413.572. The board may identify by rule circumstances under which a requirement under this section may be waived. 

      Note: See note under 413.570. 

      413.592 [Formerly 409.565; repealed by 2015 c.70 §11] 

      413.599 Rules. In accordance with applicable provisions of ORS chapter 183, the Pain Management Commission may adopt rules necessary to implement ORS 413.570 to 413.599. [Formerly 409.570]

      Note: See note under 413.570.

ORS 413.259 & 413.260, 414.655

     
      413.259 Patient centered primary care home program. (1) There is established in the Oregon Health Authority the patient centered primary care home program. Through this program, the authority shall:
      (a) Define core attributes of the patient centered primary care home to promote a reasonable level of consistency of services provided by patient centered primary care homes in this state. In defining core attributes related to ensuring that care is coordinated, the authority shall focus on determining whether these patient centered primary care homes offer comprehensive primary care, including prevention and disease management services;
      (b) Establish a simple and uniform process to identify patient centered primary care homes that meet the core attributes defined by the authority under paragraph (a) of this subsection;
      (c) Develop uniform quality measures that build from nationally accepted measures and allow for standard measurement of patient centered primary care home performance;
      (d) Develop uniform quality measures for acute care hospital and ambulatory services that align with the patient centered primary care home quality measures developed under paragraph (c) of this subsection; and
      (e) Develop policies that encourage the retention of, and the growth in the numbers of, primary care providers.
      (2)(a) The Director of the Oregon Health Authority shall appoint an advisory committee to advise the authority in carrying out subsection (1) of this section.
      (b) The director shall appoint to the advisory committee 15 individuals who represent a diverse constituency and are knowledgeable about patient centered primary care home delivery systems and health care quality.
      (c) Members of the advisory committee are not entitled to compensation, but may be reimbursed for actual and necessary travel and other expenses incurred by them in the performance of their official duties in the manner and amounts provided for in ORS 292.495. Claims for expenses shall be paid out of funds appropriated to the authority for the purposes of the advisory committee.
      (d) The advisory committee shall use public input to guide policy development.
      (3) The authority will also establish, as part of the patient centered primary care home program, a learning collaborative in which state agencies, private health insurance carriers, third party administrators and patient centered primary care homes can:
      (a) Share information about quality improvement;
      (b) Share best practices that increase access to culturally competent and linguistically appropriate care;
      (c) Share best practices that increase the adoption and use of the latest techniques in effective and cost-effective patient centered care;
      (d) Coordinate efforts to develop and test methods to align financial incentives to support patient centered primary care homes;
      (e) Share best practices for maximizing the utilization of patient centered primary care homes by individuals enrolled in medical assistance programs, including culturally specific and targeted outreach and direct assistance with applications to adults and children of racial, ethnic and language minority communities and other underserved populations;
      (f) Coordinate efforts to conduct research on patient centered primary care homes and evaluate strategies to implement the patient centered primary care home to improve health status and quality and reduce overall health care costs; and
      (g) Share best practices for maximizing integration to ensure that patients have access to comprehensive primary care, including preventative and disease management services.
      (4) The Legislative Assembly declares that collaboration among public payers, private health carriers, third party purchasers and providers to identify appropriate reimbursement methods to align incentives in support of patient centered primary care homes is in the best interest of the public. The Legislative Assembly therefore declares its intent to exempt from state antitrust laws, and to provide immunity from federal antitrust laws, the collaborative and associated payment reforms designed and implemented under subsection (3) of this section that might otherwise be constrained by such laws. The Legislative Assembly does not authorize any person or entity to engage in activities or to conspire to engage in activities that would constitute per se violations of state or federal antitrust laws including, but not limited to, agreements among competing health care providers or health carriers as to the prices of specific levels of reimbursement for health care services.
      (5) The authority may contract with a public or private entity to facilitate the work of the learning collaborative described in subsection (3) of this section and may apply for, receive and accept grants, gifts, payments and other funds and advances, appropriations, properties and services from the United States, the State of Oregon or any governmental body or agency or from any other public or private corporation or person for the purpose of establishing and maintaining the collaborative. [Formerly 442.210] 

      413.260 Patient centered primary care home health care delivery model. (1) The Oregon Health Authority, in collaboration with health insurers and purchasers of health plans including the Public Employees' Benefit Board, the Oregon Educators Benefit Board and other members of the patient centered primary care home learning collaborative and the patient centered primary care home program advisory committee, shall:

      (a) Develop, test and evaluate strategies that reward enrollees in publicly funded health plans for:

      (A) Receiving care through patient centered primary care homes that meet the core attributes established in ORS 413.259;

      (B) Seeking preventative and wellness services;

      (C) Practicing healthy behaviors; and

      (D) Effectively managing chronic diseases.

      (b) Develop, test and evaluate community-based strategies that utilize community health workers to enhance the culturally competent and linguistically appropriate health services provided by patient centered primary care homes in underserved communities.

      (2) The authority shall focus on patients with chronic health conditions in developing strategies under this section.

      (3) The authority, in collaboration with the Public Employees' Benefit Board and the Oregon Educators Benefit Board, shall establish uniform standards for contracts with health benefit plans providing coverage to public employees to promote the provision of patient centered primary care homes, especially for enrollees with chronic medical conditions, that are consistent with the uniform quality measures established under ORS 413.259 (1)(c).

      (4) The standards established under subsection (3) of this section may direct health benefit plans to provide incentives to primary care providers who serve vulnerable populations to partner with health-focused community-based organizations to provide culturally specific health promotion and disease management services. [2009 c.595 §1165; 2015 c.318 §21; 2015 c.798 §6]

      414.655 Utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations. (1) The Oregon Health Authority shall establish standards for the utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations.

      (2) Each coordinated care organization shall implement, to the maximum extent feasible, patient centered primary care homes and behavioral health homes, including developing capacity for services in settings that are accessible to families, diverse communities and underserved populations, including the provision of integrated health care. The organization shall require its other health and services providers to communicate and coordinate care with the patient centered primary care home or behavioral health home in a timely manner using electronic health information technology.

      (3) Standards established by the authority for the utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations may require the use of federally qualified health centers, rural health clinics, school-based health clinics and other safety net providers that qualify as patient centered primary care homes or behavioral health homes to ensure the continued critical role of those providers in meeting the needs of underserved populations.

      (4) In order to promote the full integration of behavioral health and physical health services in primary care, behavioral health care and urgent care settings, providers in patient centered primary care homes and behavioral health homes may use billing codes applicable to the behavioral health and physical health services that are provided.

      (5) Each coordinated care organization shall report to the authority on uniform quality measures prescribed by the authority by rule for patient centered primary care homes and behavioral health homes.

      (6) Patient centered primary care homes and behavioral health homes must participate in the learning collaborative described in ORS 413.259 (3). [2011 c.602 §6; 2015 c.798 §5]

      Note: Sections 2 and 17, chapter 798, Oregon Laws 2015, provide:

      Sec. 2. The Oregon Health Authority shall prescribe by rule standards for achieving the integration of behavioral health services and physical health services in patient centered primary care homes and behavioral health homes. [2015 c.798 §2]

      Sec. 17. Section 2 of this 2015 Act is repealed on June 30, 2017. [2015 c.798 §17]

ORS 413.248


      413.248 Physician Visa Waiver Program; rules; fees. (1) The Physician Visa Waiver Program is established in the Oregon Health Authority. The purpose of the program is to make recommendations to the United States Department of State for a waiver of the foreign country residency requirement on behalf of foreign physicians holding visas who seek employment in federally designated shortage areas. (2) A foreign physician who has completed a residency in the United States may apply to the authority for a recommendation for a waiver of the foreign country residency requirement in order to obtain employment in a federally designated shortage area in the state. Applications shall be on the forms of and contain the information requested by the authority. Each application shall be accompanied by the application fee. (3) The authority reserves the right to recommend or decline to recommend any request for a waiver. (4) The authority shall adopt rules necessary to implement and administer the program, including but not limited to adopting an application fee not to exceed the cost of administering the program. [Formerly 409.745] Note: See note under 413.246

413.233, 413.127


      413.233 Primary care provider loan repayment program; rules. (1) There is created in the Oregon Health Authority the primary care provider loan repayment program for the purpose of assisting primary care providers who have committed to serving medical assistance recipients in rural or medically underserved areas of the state.
      (2) The authority shall prescribe by rule:
      (a) Participant eligibility criteria, including the types of primary care providers who may participate in the program;
      (b) The terms and conditions of participation in the program, including the duration of the term for which a participant makes a commitment under subsection (1) of this section;
      (c) The types of loans for which payments may be provided;
      (d) The priority for distribution of funds available under ORS 413.127 if the funds are insufficient to provide assistance to all of the applicants who are eligible to participate in the program; and
      (e) The financial penalties imposed on a participant who fails to complete the term of the commitment.
      (3) The authority may enter into contracts with one or more public or private entities to administer the program or parts of the program. [2013 c.177 §1]
 
      Note: See note under 413.231.
 
      413.127 Primary Care Provider Loan Repayment Fund. (1) There is established the Primary Care Provider Loan Repayment Fund in the State Treasury, separate and distinct from the General Fund. Interest earned by the Primary Care Provider Loan Repayment Fund is credited to the fund. The Primary Care Provider Loan Repayment Fund consists of moneys appropriated from the General Fund, federal moneys received for the purpose of operating the primary care provider loan repayment program and financial penalties recovered by the Oregon Health Authority from primary care providers who fail to meet their service obligations. Moneys in the Primary Care Provider Loan Repayment Fund are continuously appropriated to the authority to be used to implement and operate the primary care provider loan repayment program.
      (2) The authority may accept gifts, grants, bequests, endowments and donations from public or private sources for deposit into the Primary Care Provider Loan Repayment Fund. [2013 c.177 §2]
      Note: 413.127 is repealed January 2, 2018. See sections 9 and 12, chapter 829, Oregon Laws 2015.
 
      Note: See note under 413.105​

413.435

      413.435 Administrative requirements for students in clinical training. (1) The Oregon Health Authority, in collaboration with the State Workforce Investment Board, shall convene a work group to develop standards for administrative requirements for student placement in clinical training settings in Oregon. The work group may include representatives of:
      (a) State education agencies;
      (b) A public educational institution offering health care professional training;
      (c) Independent or proprietary educational institutions offering health care professional training;
      (d) An employer of health care professionals; and
      (e) The Health Care Workforce Committee established under ORS 413.017.
      (2)(a) The work group shall develop standards for:
      (A) Drug screening;
      (B) Immunizations;
      (C) Criminal records checks;
      (D) Health Insurance Portability and Accountability Act orientation; and
      (E) Other standards as the work group deems necessary.
      (b) The standards must apply to students of nursing and allied health professions. The standards may apply to students of other health professions.
      (c) The standards must pertain to clinical training in settings including but not limited to hospitals and ambulatory surgical centers, as those terms are defined in ORS 442.015.
      (3) The work group shall make recommendations on the standards developed under this section and the initial and ongoing implementation of the standards to the Oregon Health Policy Board established in ORS 413.006.
      (4) The authority may establish by rule standards for student placement in clinical training settings that incorporate the standards developed under this section and approved by the Oregon Health Policy Board. [2011 c.136 §1; 2017 c.185 §10; 2017 c.297 §24]
 
      Note: See note under 413.430.