justicedao/ipfs_state_laws huggingface dataset:
409-036-0070 Application and Review Process (1) The Authority and its contracted designee have published application processes online. (2) The Authority or its contracted designee shall review those applications that meet all requirements of OAR 409-036-0020. (a) The Authority shall return incomplete applications, and upon resubmittal, they shall be processed as of the new date of receipt when they are determined complete. (b) The Authority shall notify applicants of the status of their completed applications within 90 days of application submission. (3) The Authority may consider the following factors in determining whether to accept an eligible provider for participation in the program, which include but are not limited to: (a) Ability to obtain federally-funded incentives. The Authority may prioritize applications from providers who apply to practice at a qualifying practice located in a HPSA that has been determined may not reach the threshold for federal NHSC or NurseCorps awards in a given year. (b) Other determined need of the area. The Authority may prioritize applications from providers who apply to practice at a qualifying practice located in a service area ranking below the median in the most recent Areas of Unmet Health Care Need report published by the Office. (c) PCPCH status of the practice site. The Authority may award priority to eligible providers who will provide services in, or in affiliation with, a Patient Centered Primary Care Home (PCPCH) recognized by the State of Oregon. The Authority may award a higher priority to those providers at a Tier 3 or higher recognized PCPCH site. (d) Providers located in Oregon. In the case of a provider delivering telehealth services as all or part of their services, the Authority may give providers physically located in Oregon priority for an award. (e) Provider types, disciplines, or ethnic or linguistic diversity particularly needed in a community. The Authority may give providers priority for an awardee who meets specific needs identified by a community, including ethnicity, language spoken, specialty, or provider type. (f) Community willingness to contribute to the cost of the award. The Authority may give providers priority for an award if a practice site or community agrees to share in the cost of the incentive at the time of application. (g) Demonstrated investment in integration of behavioral health or oral health services with primary care. The Authority may provide terms by which a provider may receive priority consideration if they are working at a site that is facilitating the integration of behavioral health and/or oral health services within the community. (h) Practice site client demographic represents a priority population. The Authority may give priority for an award if provider works at a practice site that serves a priority population. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 7-2022, amend filed 08/31/2022, effective 08/31/2022 OHP 1-2021, amend filed 03/29/2021, effective 03/29/2021 OHP 11-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0090 Transfer of Provider Service Obligation to Another Site (1) In the event of a practice failure or other extenuating circumstance, a participating provider with Authority approval may transfer the service obligation to another qualifying practice site. This is intended to be a rare instance and may not be granted without prior approval. A transfer without prior approval is considered a violation of the service agreement. A participating provider must submit a written transfer request to the Authority documenting the: (a) Circumstances surrounding the need to transfer; (b) Proposed new qualifying practice site; and (c) Name of the director or administrator at the proposed new practice site. (2) The participating provider must also submit: (a) A letter from the original practice site releasing the eligible provider from any employment contract (if applicable) and provide an explanation for the termination of employment. The Authority may waive this requirement if the original practice site is in non-compliance with federal requirements, federal or state law, or these rules. (b) An employment contract with the new qualifying practice site, a letter of intent from the new qualifying practice site to employ the provider, or documentation of the provider having established a sole proprietorship, Limited Liability Corporation, Limited Liability Partnership, or Professional Corporation that meets the definition of a qualifying practice site. (3) The new practice site, in collaboration with the provider, must: (a) Submit a letter of support documenting the site meets the definition in OAR 409-036-0010 (25) and providing other information as requested by the Authority. (b) Provide confirmation that the site will cooperate with the provider to comply with the monitoring and follow-up requirements set forth in these rules. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 1-2021, amend filed 03/29/2021, effective 03/29/2021 OHP 13-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0100 Suspension or Waiver of Minimum Service Obligation (1) The Authority may agree to suspend a participating provider’s service obligation for a specified time under circumstances it deems appropriate, including, but not limited to parental leave, medical leave, military service leave, or other factors beyond a provider’s control. During the time of suspension, awards shall be suspended. (2) A participant requesting a suspension of minimum service obligation shall make a written request to the Authority, citing the reasons and providing documentation of the circumstances. (3) The Authority may waive all or part of the minimum service obligation under the following circumstances: (a) Upon receipt of written documentation acceptable to the Authority of the death of the participant; (b) Upon receipt of written documentation acceptable to the Authority of the total and permanent disability of the participant; or (c) Upon receipt of written documentation of other significant changes in life circumstances that are out of the control of the participant and that the Authority determines warrant a waiver of service commitment. (4) If all or part of the minimum service obligation is waived, the Authority may not impose any penalty for failure to meet the obligation Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 14-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0110 Monitoring and Follow-up Requirements (1) To maintain participation in the program, a provider must: (a) Notify the Authority immediately upon beginning work at a qualifying practice site. (b) Promptly submit semi-annual reports signed by the provider and the administrator of the qualifying practice site verifying the provider’s employment, or licensed business (in the case of a sole provider), and providing any additional information as requested by the Authority, including but not limited to: (A) Site’s and Provider’s caseload (panel size or equivalent); (B) Site’s and Provider’s Medicaid caseload and Medicare caseload; (C) Provider full-time equivalent (FTE) status; and (D) Number and percentages of practice site’s patients whose health care is covered by Medicaid and by Medicare, and the number of patients at the practice site who are uninsured. (2) The first report is due six months after employment begins, and every six months thereafter, until the term of the contract is complete. (3) A provider participating in the program must notify the Authority immediately of any change in employment or practice status. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 15-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0130 Contributions to the Health Care Provider Incentive Fund (1) The Authority shall publish on its website terms and conditions for receipt of funds from qualifying practice sites or other sources to contribute toward the cost of the subsidies for participants. (2) The Authority shall deposit all contributions to the Health Care Provider Incentive Fund established in ORS 676.450. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 17-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0140 Program Integrity (1) The Authority shall analyze and monitor the operation of the program and audit and verify the accuracy and appropriateness of all payments made under the terms of this program. To promote the integrity of the program, the Authority may require participants and any other parties to develop and maintain adequate financial and other documentation as determined by the Board to be necessary. The Authority may communicate with and coordinate any program integrity actions with the federal and state oversight authorities. (2) Any overpayment made to an individual or carrier is subject to recovery. The Authority shall take appropriate action and may redress payment errors or false claims for payment under the program. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 18-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-036-0150 Data Sharing (1) The Authority may not share data about program participants, other than for purposes of planning, program evaluation or analysis. (2) Data may only be shared with: (a) Agencies, offices, or contractors of the Authority; (b) The Oregon Employment Department; and (c) Non-governmental not noted above only with written approval from the Director of the Authority. Statutory/Other Authority: ORS 676.454 Statutes/Other Implemented: ORS 676.454 History: OHP 19-2019, minor correction filed 07/25/2019, effective 07/25/2019 OHP 4-2017, adopt filed 12/23/2017, effective 01/02/2018
409-039-0000 Purpose These rules (OAR 409-039-0000 to 409-039-0120) establish requirements related to the maximum rates that a temporary staffing agency may charge to or receive from a hospital or facility that engages the temporary staffing agency. Statutory/Other Authority: ORS 676.716 Statutes/Other Implemented: ORS 676.716 History: OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0020 Scope and Applicability; Exceptions These rules apply to temporary staffing agencies, facilities, and hospitals, except as provided below: (1) These rules do not apply to Indian Health Care Providers or Indian Health Programs. (2) A temporary staffing agency engaged by a hospital to provide 25 or fewer personnel in a single licensed care setting may charge to and receive from a hospital, rates that exceed the maximum bill rates set under OAR 409-039-0040. This 25 or fewer exception applies collectively to all personnel provided by a temporary staffing agency for each single licensed care setting. This applies: (a) Per licensed facility, and (b) Per work order or contract. Statutory/Other Authority: ORS 676.716 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0030 Health Professions (Personnel) Covered (1) Facilities: For facilities, the maximum bill rates established in OAR 409-039-0040 apply to the following categories of personnel: (a) Registered nurse, (b) Licensed practical nurse, (c) Certified medical assistant, (d) Certified nursing assistant, and (e) Direct caregiver who provides health care services or assistance with activities of daily living to clients, residents, or patients. (2) Hospitals: Maximum bill rates apply to a registered nurse or certified nursing assistant providing health care services to patients. Statutory/Other Authority: ORS 676.716 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0040 Maximum Rates for a Hospital or Facility (1) The maximum bill rates a Temporary Staffing Agency may charge to or receive from hospitals and facilities, as described in Section 3 of this rule: (a) Are based on the most recently available wage data from the Oregon Employment Department and include any applicable fringe benefits, charges for administrative and contract fees and other special charges; and (b) Bear a reasonable relationship to this wage data from the Oregon Employment Department. (2) The differences in the maximum bill rates established in this rule are based on the following factors: (a) The minimum wages in geographic regions of this state; (b) Shift differentials; (c) Holiday pay; (d) Type of licensed care setting; (e) Relevant state and federal regulatory requirements; (f) Personnel with specialty training; and (g) Information obtained through consultation with temporary staffing agencies and their representatives and providers of long-term care services, acute care services, and primary care services, or representatives of the providers described in this paragraph. (3) The maximum bill rates established under this Section include the maximum Agency Margin rate a temporary staffing agency can charge for each respective position. The maximum Agency Margin is 34.2%. (4) Maximum Bill Rates for a Hospital or Facility are effective as follows: (a) For calendar year 2025, maximum bill rates are effective starting January 1, 2025, and apply to rates negotiated on or after January 1, 2025. (b) For calendar year 2026, maximum bill rates are effective starting January 1, 2026, and apply to rates negotiated on or after January 1, 2026. (c) For calendar year 2027 and later, maximum bill rates will be published in the fourth quarter of the prior year and are effective January 1st of each year for service dates on or after January 1st. (5) Calendar year 2026 maximum bill rates are listed in 409-039-0040 Table 1. [ED. NOTE: To view attachments referenced in rule text, click here to view rule.] Statutory/Other Authority: ORS 676.716 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0050 Waivers to Charge More than the Maximum Bill Rates A temporary staffing agency, hospital, or facility may apply for a waiver of the maximum bill rates described in ORS 676.716 in either of the following two circumstances. (1) Emergency Waiver. A hospital, facility or temporary staffing agency that intends to engage at a rate higher than a maximum rate established under ORS 676.716, in order to respond to an Emergency or state of emergency, may request an Emergency Waiver of the maximum bill rates pursuant to the process outlined in OAR 409-039-0060 in the following circumstances: (a) There is an Emergency; (b) A state of emergency is declared pursuant to ORS 401.165; or (c) The Governor declares a public health emergency pursuant to ORS 433.441. (2) Non-Emergency Waiver: A temporary staffing agency, hospital, or facility may apply to the Authority for a Non-Emergency Waiver of the maximum bill rates pursuant to the process outlined in OAR 409-039-0070 if the applicant clearly demonstrates to the Authority that: (a) It has made reasonable, good faith efforts to stay within the maximum bill rates; (b) It has exhausted all other possibilities to stay within the maximum bill rates; and (c) An acute incident has occurred, or an imminent event is anticipated, that the applicant expects will substantially and negatively impact access to care. (3) Waivers approved by the authority permit a Temporary Staffing Agency to exceed the maximum bill rate for a certain period of time. Maximum Agency Margin must not exceed the percentage specified in OAR 409-039-0040(3). Statutory/Other Authority: ORS 676.722 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0060 Application Process and Review of Emergency Waiver Requests (1) A hospital, facility, or temporary staffing agency requesting to waive the maximum bill rate established in OAR 409-039-0040 for circumstances outlined in OAR 409-039-0050(1) must submit a request for an Emergency Waiver to the Authority. (2) An Emergency Waiver request required to be filed under Section (1) of this rule will be submitted using the form available at the Program Website. (3) An initial request submitted to the Authority requesting an Emergency Waiver will be automatically approved and issued by the Authority upon submission. (4) An Emergency Waiver automatically approved and issued under Section (3) of this rule is valid for 90 calendar days and may be renewed. Upon expiration of the Emergency Waiver, the temporary staffing agency, hospital, or facility must comply with the maximum bill rates established in OAR 409-039-0040 unless a renewal is timely requested and approved by the Authority pursuant to Section (5) of this rule. (5) An Emergency Waiver waiving the maximum bill rates established in OAR 409-039-0040 for circumstances outlined in OAR 409-039-0050(1) may be renewed and issued to a hospital, facility, or temporary staffing agency that possesses a license, certification or registration in good standing to operate in Oregon. A temporary staffing agency, hospital, or facility may submit a request to renew an Emergency Waiver under this Section for an additional 90 calendar day period. (a) The Authority will approve or deny a request to renew an Emergency Waiver within three (3) business days after such request is received by the Authority. (b) Such request must be made no sooner than 10 business days before, or no later than four (4) business days prior to, the expiration date of the Emergency Waiver. (c) For the purposes of this rule, a request to renew an Emergency Waiver that is filed with the Authority on or after 4:00 p.m. on a weekday, or on a Saturday, Sunday, or legal holiday, will be considered received on the next following business day. (6) Upon approval of an Emergency Waiver under this rule, a temporary staffing agency engaged by a hospital or facility for which an emergency waiver is issued under this rule may charge to or receive from the hospital or facility rates consistent with the Emergency Waiver. Statutory/Other Authority: ORS 676.722 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0070 Application Process and Review of Non-Emergency Waiver Requests (1) A Non-Emergency Waiver waiving the maximum bill rates established in OAR 409-039-0040 for circumstances outlined in OAR 409-039-0050(2) may be issued to a hospital, facility, or temporary staffing agency that possesses a license, certification or registration in good standing to operate in Oregon. A hospital, facility, or temporary staffing agency requesting such waiver must submit a request for a Non-Emergency Waiver to the Authority. (2) A Non-Emergency Waiver request required to be filed under Section (1) of this rule will be submitted using the form available at the Program Website. (3) A Non-Emergency Waiver requested may be for a period of 30, 60 or 90 calendar days. A temporary staffing agency, facility, or hospital may request to renew an approved Non-Emergency Waiver. (a) A request to renew a Non-Emergency Waiver must be filed with the Authority no sooner than 25 business days before, and no later than twelve (12) business days before, the approved Non-Emergency Waiver is set to expire. (b) Upon expiration of the Non-Emergency Waiver, the temporary staffing agency, hospital, or facility must comply with the maximum bill rates established in OAR 409-039-0040 unless a renewal is timely requested and approved by the Authority. (4) The Authority will approve or deny a request for a Non-Emergency Waiver made pursuant to Section (1) of this rule or a request to renew an approved Non-Emergency Waiver pursuant to Section (3) of this rule within ten (10) business days after request is received by the Authority. (5) For the purposes of this rule, a request to renew an Emergency Waiver that is filed with the Authority on or after 4:00 p.m. on a weekday, or on a Saturday, Sunday, or legal holiday, will be considered received on the next following business day. (6) A temporary staffing agency, hospital, or facility for which a Non-Emergency Waiver is approved under this rule may charge and/or pay rates consistent with the terms of the Non-Emergency Waiver. (7) Upon expiration of the Non-Emergency Waiver, or renewed Non-Emergency Waiver, the temporary staffing agency, hospital, or facility must comply with the maximum bill rates established in OAR 409-039-0040. Statutory/Other Authority: ORS 676.722 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2025, temporary amend filed 11/26/2025, effective 11/26/2025 through 12/31/2025 OHP 4-2025, amend filed 11/26/2025, effective 11/26/2025 OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024
409-039-0080 Reconsideration Process for Denied Waivers (1) A temporary staffing agency, facility, or hospital may submit a request for the Authority to reconsider a decision to deny a request to renew an Emergency Waiver under OAR 409-039-0060, or a Non-Emergency Waiver, including a renewal, under OAR 409-039-0070. (2) A request for reconsideration under Section (1) of this rule will be submitted using the form available at the Program Website. (3) A request for reconsideration must be submitted within ten (10) business days of a denial. (4) The Authority will render a determination on a request for reconsideration filed pursuant to Section (1) of this rule within ten (10) business days after the date such request is received by the Authority. (5) For the purposes of this rule, a request to renew an Emergency Waiver that is filed with the Authority on or after 4:00 p.m. on a weekday, or on a Saturday, Sunday, or legal holiday, will be considered received on the next following business day. (6) If the Authority denies the request for reconsideration, the requestor may appeal the denial by requesting a contested case hearing. The appeal must be filed with the Authority within 15 calendar days from the date of service of the denial. (a) Contested case hearings will be conducted pursuant to ORS Chapter 183 and the Attorney General's Uniform and Model Rules of Procedure for the Office of Administrative Hearings. (b) The requestor will have the burden to prove a compelling need for the Emergency Waiver or Non-Emergency Waiver. (c) The issues to be considered in a contested case hearing conducted pursuant to this rule will be limited in scope to the facts and conclusions contained in the Authority’s denial. Statutory/Other Authority: ORS 676.722 Statutes/Other Implemented: ORS 676.695 - 676.725 History: OHP 5-2024, adopt filed 11/22/2024, effective 11/25/2024