Oregon Administrative Rules › Chapter 409 - OREGON HEALTH AUTHORITY, HEALTH POLICY AND ANALYTICS › Division 70 - HEALTH CARE MARKET OVERSIGHT PROGRAM › Section 409-070-0060 - Comprehensive Review of a Notice of a Material Change Transaction

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Pursuant to ORS
			 415.501(7), the
			 Authority shall conduct a comprehensive review of a proposed transaction if the
			 Authority determines not to approve the transaction at the conclusion of its
			 preliminary review.
(2) The
			 Authority shall notify the entity that submitted the notice of material change
			 transaction if a comprehensive review will occur. The Authority shall notify
			 the entity that submitted the notice of material change transaction if the
			 Authority requires additional information from any of the parties to the
			 transaction. The entity is required to respond to the Authority's request for
			 additional information within 15 calendar days from the date the Authority sent
			 such request unless the Authority and entity mutually agree on a different
			 timeline.
(3) The Authority shall
			 notify the entity that submitted the notice of material change transaction the
			 fee amount associated with the comprehensive review. A party to the transaction
			 shall pay the fee amount in full no later than 30 calendar days after the date
			 the Authority sent such notification.
(4) The Authority shall issue proposed
			 findings of fact and conclusion of law, along with the Authority's proposed
			 order at the conclusion of its comprehensive review and shall allow the parties
			 and the public a reasonable opportunity to make written comments to the
			 proposed findings and conclusions and the proposed order. If the comprehensive
			 review includes a community review board, recommendations of the community
			 review board shall be in writing and appended to the proposed order. Unless
			 otherwise directed by the Authority, written comments to the proposed findings
			 and conclusions and the proposed order shall be filed with the Authority within
			 thirty calendar days following publication. The Authority shall make any filed
			 comments available to the public promptly following receipt.
(5) The Authority shall consider the parties'
			 and the public's written exceptions and issue a final order setting forth the
			 Authority's findings and conclusions in respect of the proposed transaction. If
			 the comprehensive review included a community review board, the Authority's
			 findings and conclusions shall include an explanation of the reasons why the
			 Authority accepted, rejected or modified the recommendations of the community
			 review board.
The final order shall include any commitments by the health
				care entity to continue services currently provided by the health care entity.
				A party to the proposed transaction may contest the final order as provided in
				OAR 409-070-0075.
(6)
			 Subject to any conditions prescribed under OAR 409-070-0065, the Authority
			 shall approve a material change transaction that does not involve a domestic
			 insurer, or in the case of a material change transaction involving a domestic
			 health insurer, recommend to the Department that the transaction be approved,
			 if pursuant to ORS 415.501(9), the
			 Authority determines that the transaction satisfies (a) below and also
			 satisfies either (b) or (c) below:
(a) There
			 is no substantial likelihood that the transaction would:
(A) Have material anticompetitive effects in
			 the region (such as significantly increased market concentration among
			 providers when contracting with payers, carriers, or coordinated care
			 organizations, or among carriers when establishing health benefit premiums that
			 is likely to increase costs for consumers) not outweighed by benefits in
			 increasing or maintaining services to underserved populations;
(B) Be contrary to law;
(C) Jeopardize the financial stability of a
			 health care entity involved in the transaction; or
(D) Otherwise be hazardous or prejudicial to
			 consumers or the public.