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COVID-19

Physician Assistant Practice During Governor Declared Emergency

House Bill 4212 (2020 Special Session) sections 44-47 are intended to increase the health care workforce in response to the COVID-19 declared emergency. These provisions are effective June 30, 2020, through the duration of the COVID-19 state of emergency issued by the Governor of Oregon. The bill provides:

  • To ensure that PAs are part of dynamic and flexible health care teams during this emergency, Oregon PAs may provide patient care without formally entering into a practice agreement on file with the OMB if the medical services are within the PA's scope of practice and if the services are within the guidelines and standards established by a supervising physician. It is up to the facility to determine what documentation is needed and to the supervising physician to ensure that the PA understands and practices in compliance with the established protocols and guidelines.
  • Requirements for chart review and onsite supervision are suspended during the state of emergency.
  • PAs with an Oregon license or with a temporary authorization to practice in Oregon under OAR 847-010-0068 may practice medicine via telehealth for Oregon patients. If a patient is located outside of Oregon, you must consult with the state regulatory authority for the state in which the patient is located before providing patient care.

The global spread of COVID-19 (Novel Coronavirus) is an emerging, rapidly evolving situation.  

The OMB’s mission of protecting Oregonians and ensuring access to care is even more critical during this public health emergency.  We are working hard to be part of the solution in this time of great need. The following COVID-19 information is provided on this webpage to assist Oregon Medical Board licensees.

ALERT: FDA Guidance Restricts Use of KN95 Respirators

Guidance During COVID-19 (NEW: FSMB Statement on Wearing Face Coverings During Patient Care)

Increasing Physician/PA Workforce

COVID-19 Emergency Response Opportunities

Acupuncture Information

Liability Limitations & Malpractice Coverage

Oregon COVID-19 Webinars & Trainings

Telemedicine, Billing, and HIPAA

Public Health Reporting

Physician Assistant 8-Hour On-Site Supervision

Respiratory Therapist Licensure

Medical Office Closures

Continuing Education Requirements

AMA: Ethical Obligations of Physicians

Additional Resources


ALERT: FDA Guidance Restricts Use of KN95 Respirators

Following a federal decision to restrict the use of KN95-style respirators for medical use in the United States, Oregon health and safety officials advise medical professionals to stop using KN95 respirators, in accordance with the Food and Drug Administration (FDA) guidance.  

Under an Emergency Use Authorization, the FDA previously allowed the use of KN95s for U.S. health care workers in the fight against the COVID-19 pandemic. On Thursday, the FDA revoked that authorization for more than 65 of the 80 authorized manufacturers, citing poor quality. The FDA guidance can be found here.

The Oregon Health Authority (OHA) and Oregon’s Occupational Safety and Health Administration (OSHA) want to inform Oregonians this guidance applies only to the use of KN95 respirators. The FDA announcement does not impact other personal protective equipment, including N95 masks, which are safe to use.

Click here for more information.


Guidance During COVID-19

The Oregon Medical Board understands physicians and physician assistants are changing their practices to adhere to the Governor’s Executive Orders. The Board supports our licensees in this effort and understands that care may be delayed or otherwise impacted.  

How can I restart my practice? Governor Kate Brown has released a public health framework for restarting public life and business in Oregon. This plan outlines the necessary tasks, discrete steps, and guidelines for step-by-step reopening. Among those important tasks is a look at how and when to resume non-emergent and elective procedures requiring personal protective equipment (PPE) that were cancelled as a result of Governor Brown’s Executive Order No. 20-10. Hospitals, surgical centers, medical offices, and dental offices that meet the requirements established in the framework will be able to resume non-urgent procedures on May 1, 2020. Please review the Oregon Health Authority’s (OHA) guidance for details about resumption of non-emergent and elective procedures.

Please note the Oregon Medical Board is unable to provide guidance regarding this order. Please direct all questions to the OHA at COVID.19@dhsoha.state.or.us. The Oregon Medical Board cannot provide legal or medical advice; however, it is good practice to carefully document your decision-making process.  

What will the Board do if a patient complains about my decision? The Oregon Medical Board understands the complexity of providing care during the COVID-19 outbreak. In evaluating any complaints filed against a licensee for care that was delivered during this period, the Board will look to all of the circumstances to determine whether the physician or physician assistant met the standard of care relevant to the current environment as outlined in ORS 677.095(1).

What will the Board do if a licensee does not follow precautions set out by the Governor's Executive Order and the Oregon Health Authority? Noncompliance with Executive Orders and applicable Oregon Health Authority (OHA) guidance may result in disciplinary action by the Oregon Medical Board. Unprofessional conduct in ORS 677.190 as defined in ORS 677.188 includes, but is not limited to, conduct that does or might endanger the health or safety of the public. This includes failure to comply with an Executive Order issued by the Governor or failure to comply with state agency guidance applicable to the time and location where the licensee practices medicine. Questions regarding the OHA guidance may be directed to the OHA at covid.19@dhsoha.state.or.us.

NEW - FSMB Statement on Wearing Face Coverings During Patient Care: The Federation of State Medical Boards' Board of Directors released the following statement in response to reports from a number of state medical boards of complaints they are receiving about physicians and physician assistants failing to wear face coverings during patient care: 

“Wearing a face covering is a harm-reduction strategy to help limit the spread of COVID-19, especially since physical distancing is not possible in health care settings. When seeing patients during in-person clinical encounters, physicians and physician assistants have a professional responsibility to wear a facial covering for their own protection, as well as that of their patients and society as a whole."

Increasing Physician/PA Workforce

The Oregon Medical Board has taken emergency action to increase the physician/PA workforce in Oregon.  These provisions were adopted in a temporary rule, which is effective now. Review the rule language here: OAR 847-010-0068. 

Three efforts to increase our physician and PA workforce:

  1. Emeritus and Locum Tenens physicians and PAs – current administrative restrictions are lifted during this emergency.

    1. Emeritus licensees are no longer restricted to volunteer practice only.  During this emergency, they may receive payment for their medical care.  

    2. Locum Tenens licensees are no longer limited to 240 days/biennium of practice in Oregon.  During this emergency, they may practice indefinitely in our state.  

  2.  Administrative Medicine/Inactive/Lapsed/Retired physicians and PAs – a new expedited reactivation process is in place during this emergency.

    1. To qualify, a licensee must have been in active clinical practice within the previous three years and must have been in good standing at the time the Oregon license status became Administrative Medicine, Inactive, Lapsed, or Retired.

    2. To apply, submit the Emergency Reactivation Application and supplemental materials.

  3. Out-of-state physicians and PAs coming into Oregon.

    1. To qualify, an out-of-state physician or PA must be actively licensed and in good standing in another state.

    2. To apply, submit the Emergency Authorization Application and supplemental materials. 

Note: Any restrictions or requirements placed on a licensee through a Board Order or Agreement remain in effect during the emergency.


COVID-19 Emergency Response Volunteer Opportunities (SERV-OR)

The State Emergency Registry of Volunteers in Oregon (SERV-OR) is a statewide pool of licensed physicians, nurses, pharmacists, Emergency Medical Technicians (EMTs), behavioral health providers, respiratory therapists and other health professionals who are willing to volunteer in response to Federal, State, and/or local emergencies. Due to COVID-19, health care resources are strained and SERV-OR is calling for licensed health care professionals to sign up, train, and deploy in support of Oregon's COVID-19 pandemic response.

How can you help? There are several ways to help, depending on the need. You may be asked to:

  • Staff an alternate care site to decrease pressure on hospitals
  • Operate a health information hotline
  • Help with contact investigation around known COVID-19 cases
  • Support administrative or logistical needs within the OHA Agency Operations Center
  • Lend your skills in a wide variety of other volunteer roles

For more information, visit the SERV-OR website or the OMB’s Volunteer for Public Emergencies page. To register with SERV-OR, click here. If you have questions or need technical assistance, contact SERV.OR@dhsoha.state.or.us.


Acupuncture Information

Oregon licensed acupuncturists restarting clinical services on May 1 must implement a strict screening process and adhere to social distancing measures and other precautions set out by the Governor's Executive Order and the Oregon Health Authority (OHA). Acupuncturists may continue offering telehealth services within Oregon if telehealth meets the standard of care for the particular patient and condition being treated. The OHA also provides additional guidance on these Executive Orders. Questions regarding these guidelines may be directed to the OHA at covid.19@dhsoha.state.or.us.

For questions or assistance about acupuncture license renewal, please contact the Licensing Call Center, Monday - Friday, 9 a.m. - noon and 1 p.m. - 3 p.m. at licensing@omb.oregon.gov or 971-673-2700. General information on license renewal is available online.

For detailed guidance on reopening acupuncture clinics, please refer to the Oregon Association of Acupuncturists' Recommendations for Establishing Workflow and Safety as you Reopen your Clinics document.


Liability Limitations & Malpractice Coverage

The Oregon Medical Board is unable to advise licensees on malpractice insurance coverage decisions during this public health emergency. Please contact the institution where you are providing care during this emergency and/or your professional liability carrier for questions about malpractice insurance coverage.

For information about federal and state liability limitations during the this public health emergency and malpractice insurance resources, please review the Board’s Informational Summary.

Federal law (CARES Act, H.R. 748, Section 3215) provides that health care professionals are not liable under Federal or State law for harm caused by an act or omission while volunteering (not receiving payment) their health care services during the COVID–19 public health emergency in response to the public health emergency. The federal limitation is not a substitute for insurance coverage; for additional information see the Board’s Informational Summary.

In Oregon, the Liability Limitation for Volunteer Services Program is provided by Oregon law to limit the liability for health practitioners who provide services without compensation. The program is not a substitute for insurance coverage; rather Oregon law (ORS 676.340-676.345) limits the liability for health practitioners who meet the requirements of the program and have registered with the Board. Program requirements and patient notice forms are available on the Liability Limitation Program page.


Oregon COVID-19 Webinars & Trainings

OHA Health Care Provider Webinar - Tuesdays from noon to 1:00 p.m., hosted by OHA’s Chief Medical Officer Dr. Dana Hargunani. Session information and past sessions are available here: Information Sessions.
Questions? Contact COVID.19@dhsoha.state.or.us.

Project ECHO Sessions for Clinicians - Thursdays, noon to 1:15 p.m., hosted by Oregon ECHO Network, OHA, and County Public Health Officials. View the  Weekly Informational Session Flyer for links to the sessions. Oregon clinicians are encouraged to register here. Session information and past sessions are available here: Information Sessions.
Questions? Contact oen@ohsu.edu.

Disaster Behavioral Health Online Trainings for Health Care Professionals & First Responders, offered by OHA. Click here for the training schedule and to register. Additional offerings will be posted through the months of April and May.

Suicide Prevention Resource Center: videos and resources for treating suicidal patients during COVID-19.

Telemedicine Information

Physicians with an active status license to practice medicine in Oregon may provide care via telemedicine to their Oregon patients. Out-of-state physicians with a telemedicine license to practice medicine in Oregon may provide remote care to their Oregon patients.* Physician Assistants with an active Oregon license or with a temporary authorization to practice in Oregon under OAR 847-010-0068 may practice medicine via telehealth for Oregon patients during the declared emergency as provided in HB 4212 (2020 Special Session).

For more information regarding telemedicine rules and licensure qualifications in Oregon, please visit our website.

Licensees interested in setting up telemedicine services can visit the Medical Society of Metropolitan Portland's website for assistance and resources.

Billing

  • If you have questions or concerns about billing for telemedicine appointments, visit the Department of Financial Regulation’s (DFR) Coronavirus Insurance Information Page, available here. Please note that the Board is not able to assist with insurance billing issues – all inquiries will be directed to the DFR.
  • The Oregon Health Authority has announced the following temporary administrative orders and rule changes for Medical Assistance Program reimbursement:
    • OAR 410-130-0610: Amends telemedicine rule to align with updated practice guidelines and reduce barriers for evaluation and management of care by telemedicine during an infectious disease outbreak
    • OAR 410-141-3830: Updates to the prioritized list of covered health services to improve access to telehealth
    • You can also view all recent temporary rulemaking notices here.
  • For the duration of the COVID-19 outbreak, or until otherwise directed by the directors of the Department of Consumer and Business Services and the Oregon Health Authority, the state of Oregon expects health plans of all types to provide increased access to health care services through telehealth delivery platforms and to encourage patients to use telehealth delivery options to limit the amount of in-person health care they seek. This includes commercial health plans regulated by DCBS and Medicaid health plans regulated by OHA. Click here for full details. 
  • The Center for Medicare and Medicaid Services (CMS) released new guidelines authorizing Medicare payment for telehealth services regardless of the patient's location (at a facility or in their home).
    • The accompanying fact sheet includes information on which providers may provide telehealth services during the public health emergency (see Question #6). 
    • New: The CMS recently released additional blanket waivers to address hospital staffing issues and to increase access to Medicare telehealth services. Click here to read the fact sheet. 
  • The American Medical Assoiation has released a guide containing special coding advice to help providers receive compensation for telehealth services during the COVID-19 pandemic. Click here for full information.
  • Health Evidence Review Commission (HERC) Billing Guidance - this document includes new codes for serological COVID-19 antibody tests, COVID-19 related diagnoses, and telemedicine codes.

HIPAA Compliance

  • The U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced that it will not impose penalties for noncompliance with HIPAA regulatory requirements if health care providers provided telehealth in good faith during the COVID-19 nationwide public health emergency.
  • The OMB is unable to provide guidance on how to set up a telemedicine practice. You may wish to consult your technology staff or your legal counsel to ensure you are in compliance with federal regulations.

Policy Changes and Temporary Rulemaking

Prescribing Opioids via Telehealth

Per new clarification from the U.S. Drug Enforcement Agency (DEA), health care professionals can now prescribe a controlled substance to a patient using telehealth technology without first conducting an in-person evaluation if the following conditions are met:

  • The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of their professional practice.
  • The telemedicine communication is conducted using an audio-visual, real-time, two-way interactive communication system.
  • The practitioner is acting in accordance with applicable Federal and State law.
For more details and information, click here. 

*Note: Out-of-state Licensees who hold an active license at telemedicine status have the same duties and responsibilities and are subject to the same penalties and sanctions as any other licensed physician in Oregon. Physicians with telemedicine status in Oregon may not act as a dispensing physician, treat a patient for intractable pain, act as a supervising physician of a licensed physician assistant or an Oregon-certified First Responder or Emergency Medical Technician.


Public Health Reporting

OHA has adopted temporary rules to add a definition of COVID-19, add COVID-19 to the list of diseases reportable to public health authorities within 24 hours, and exclusions for COVID-19 at schools, children's facilities, food service facilities, and health care facilities. Please see OHA’s Emergency Rule: COVID-19 webpage for additional information.

Please visit OHA's COVID-19 web page — healthoregon.org/coronavirus — for more information and updates. Click here for OHA's COVID-19 Health Care Partner Resources page.

Licensees with COVID-19 exposure questions or concerns should contact the OHA Acute and Communicable Disease Prevention Section at 971-673-1111.


Physician Assistant 8-Hour On-Site Supervision

The OMB is waiving the requirement for 8 hours of on-site supervision of physician assistants for the months in which Oregon is under a declared state of emergency. Supervising physicians do not need to submit a letter requesting the waiver during this emergency.

Respiratory Therapists Licensed in Other States

Since the declaration of a state of emergency, OHA's Health Licensing Office has received inquiries regarding out-of-state respiratory therapists mobilizing to Oregon to assist with the COVID-19 outbreak.

In accordance with ORS 676.568(1)(o) and OAR 331-030-0025 the Office has authority to issue authorizations to individuals authorized to practice respiratory therapy in another state if the Governor of Oregon declares a state of emergency.

Respiratory therapists from out-of-state who have been requested to provide respiratory therapist services in Oregon due to the Governor declared state of emergency must send specific information to HLO. 

Click here for more information.

Medical Office Closures

The OMB is unable to provide guidance to licensees regarding office closures. Please closely and carefully monitor the situation and make an informed decision on behalf of your patients, your staff, and yourself. Visit healthoregon.org/coronavirus for the latest updates and guidance.

Continuing Education Requirements

The Oregon Medical Board will continue monitoring the impact of COVID-19 on our licensee's ability to complete continuing education courses. Please review additional continuing education information here.

AMA: Ethical Obligation of Physicians

From OMB Medical Director Dr. David Farris: Do OMB licensees have an ethical obligation to be involved in the COVID-19 pandemic? The American Medical Association says yes. Click here to read why.

Additional Resources


NEW: Online COVID-19 Testing Site Locator - The Oregon Health Authority has launched an online COIVD-19 test site locator to help Oregonians across the state find testing sites in their community. The interactive map is available in both English and Spanish, as well as several other languages. Oregon's testing guidance encourages testing for anyone with symptoms in consultation with a health care provider.

Free UpToDate COVID-19 Content:



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