reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-3200 - Grounds for Agency Sanctions; Sanctions

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The following may result in the
			 imposition of a sanction against an agency:
(a) Interference with the investigation of
			 health care fraud;
(b) Conviction
			 for unlawfully manufacturing, distributing, prescribing, or dispensing a
			 controlled substance;
(c) An action
			 by a state licensing authority relating to a provider's professional
			 competence, professional conduct, or financial integrity, that results in the
			 provider either:
(A) Having their license
			 suspended or revoked; or
(B)
			 Surrendering the license while a formal disciplinary proceeding was pending
			 before a licensing authority.
(d) Suspension or exclusion from
			 participation in a federal or state-administered health care program for
			 reasons related to professional competence, professional performance, or other
			 reason;
(e) Threatening,
			 intimidating or harassing clients or their relatives in an attempt to influence
			 payment rates or affect the outcome of disputes between the provider and the RH
			 Program;
(f) Participation in
			 collusion that resulted in an inappropriate money flow between the parties
			 involved, for example, referring clients unnecessarily to another
			 provider;
(g) For claims paid using
			 CCare funds, any sanctions outlined in OAR 410-120-1400  (HSD Medicaid Programs,
			 General Administrative Rules);
(h)
			 Unauthorized or unlawful disclosure of client information; and
(i) Failure to comply with these
			 rules.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-3210 - Agency Requests for Reconsideration

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An agency may request reconsideration of
			 a RH Program decision that directly adversely affects the agency such as:
(a) A denial or limitation of payment allowed
			 for services or items provided.
(b)
			 A RH Program overpayment determination made under OAR 333-004-3180  (Recovery of
			 RH Access Fund Overpayments to Agencies Resulting from Review or
			 Audit).
(c) A sanction other than
			 termination.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-3220 - Agency Requests for Contested Case Hearings

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An applicant agency or an agency may
			 request a contested case hearing:
(a) If a
			 new or renewal application for certification is denied.
(b) If the RH program proposes to terminate
			 an agency's certification.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-3230 - Discretionary Use of Funds

Current through Register Vol. 63, No. 7, July 1, 2024
The RH Program may, at its discretion, use RH GF or Title X
				instead of CCare to reimburse an agency for CCare-covered services, referenced
				in OAR 333-004-3070(3)(a)  (RH Access Fund Covered Services by Funding Source),
				provided to clients who may otherwise be eligible for CCare, in which case OAR
				333-004-3090(1)(b)  (Client Eligibility for the RH Access Fund) will not
				apply.
Statutory/Other Authority: ORS
				  413.042, ORS
				  414.432,
				  ORS
				  431.147,
				  ORS
				  431.149  & OL 2022, ch. 45, sec 10
Statutes/Other Implemented: ORS
				  414.432,
				  ORS
				  431.147,
				  ORS
				  413.032  & OL 2022, ch. 45, sec 10
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-3240 - Effective Date; Applicability

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 An agency certified by the RH Program before October 27, 2022 shall continue to
			 operate under the Certification Requirements for RHCare Clinics Version 2,
			 Certification Requirements for CCare Clinics Version 1, and/or Certification
			 Requirements for AbortionCare Clinics Version 2, incorporated by reference,
			 until:
(a) The agency applies for
			 recertification under the version of OAR 333-004-3010  to OAR 333-004-3240  effective October 27, 2022; or
(b)
			 February 1, 2023, at which time the agency's certification and MSA will be
			 terminated.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4000 - Description of Abortion Access Plan

Current through Register Vol. 63, No. 7, July 1, 2024
The purpose of OAR 333-004-4000  through 333-004-4130  is to
				establish requirements for the Abortion Access Plan under which authorized
				providers and agencies may receive reimbursement from the Oregon Health
				Authority for abortion services provided to individuals enrolled in health
				benefit plans described in ORS
				743A.067(7)(e) and
				(9).
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in OAR 333-004-4000  through 333-004-4130, the following
				definitions apply:
(1) "Abortion
			 Access Plan" means the program, administered by the Reproductive Health Program
			 (RH Program), under which authorized providers and agencies may bill and
			 receive reimbursement for abortion services provided to eligible
			 clients.
(2) "Abortion services"
			 means procedural abortions, medication abortions, anesthesia, and long-acting
			 reversible contraceptive (LARC) insertions associated with abortion
			 visits.
(3) "Authorized agency"
			 means an entity that has met the criteria outlined in OAR
			 333-004-4050.
(4) "Authorized
			 provider" means a provider who has met the criteria outlined in OAR
			 333-004-4050.
(5)
"
Claims form
"
means the mechanism by which authorized
			 providers bill the RH Program for abortion services provided to eligible
			 clients.
(6) "Eligible client"
			 means a client who is enrolled in a health plan that excludes coverage for
			 abortion services per ORS
			 743A.067(7)(e) and
			 (9).
(7) "Entity" means a business entity offering
			 health care services that includes abortion services.
(8) "Provider" means a health care provider
			 licensed in the state in which they are practicing, with a scope of practice
			 that includes the provision of the abortion services for which the provider is
			 seeking reimbursement and who is qualified to perform the abortion services for
			 which the provider is seeking reimbursement.
(9) "Reproductive Health Program" or "RH
			 Program" means the program within the Center for Prevention and Health
			 Promotion (Center) of the Oregon Health Authority that administers the Abortion
			 Access Plan.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4020 - Covered Services

Current through Register Vol. 63, No. 7, July 1, 2024
The Abortion Access Plan covers abortion services.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4030 - Excluded Services

Current through Register Vol. 63, No. 7, July 1, 2024
Services not listed as covered services in OAR 333-004-4020  are
				not covered by the Abortion Access Plan.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4040 - Client Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
To be eligible to have abortion services covered by the
				Abortion Access Plan, an individual must:
(1) Be an eligible client; and
(2) Have received services from an authorized
			 agency or authorized provider that submits a claim for reimbursement using the
			 RH Program-approved Abortion Access Plan claims form.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4050 - Eligibility for Reimbursement

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 To be considered an authorized agency or authorized provider and certified to
			 receive reimbursement for abortion services covered by the Abortion Access Plan
			 for clients an entity or provider must:
(a) Be
			 enrolled with the Oregon Health Authority, Health Systems Division and have met
			 all requirements outlined in OAR 410-120-1260;
(b) Be certified with the RH Program as an
			 AbortionCare agency per OAR 333-004-3030(3); or
(c) Have an active vendor account with the
			 State of Oregon.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4060 - Abortion Access Plan Billing and Claims

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An authorized agency or authorized
			 provider shall complete all required fields on the Abortion Access Plan claims
			 form prior to submission to the RH Program.
(2) An authorized agency or authorized
			 provider must not seek payment from an eligible client, or from a financially
			 responsible relative or representative of that eligible client, for any
			 services covered by the Abortion Access Plan. The authorized agency or
			 authorized provider shall accept reimbursement from the RH Program for any
			 covered services as defined in OAR 333-004-4020  (Covered Services) as payment
			 in full.
(a) An eligible client may be billed
			 for services that are not covered by Abortion Access Plan, unless the
			 authorized agency or provider misrepresented coverage of the service to the
			 eligible client.
(b) Eligible
			 clients must be informed by the authorized agency or authorized provider prior
			 to their visit that they may be billed for services not covered by the Abortion
			 Access Plan.
(c) Authorized
			 agencies or authorized providers may not request a deposit from the eligible
			 client in advance of services covered by the Abortion Access Plan.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4070 - Timely Submission of Claims

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Claims are processed once a month. To be included in a given month's
			 processing, an authorized agency or authorized provider must submit a claim to
			 the RH Program using the Abortion Access Plan claims form by electronic mail
			 before the monthly processing deadline.
(2) The RH Program shall pay claims within 12
			 months of the date of service. Claims submitted more than 12 months after the
			 date of service shall be rejected.
(3) Errors causing rejection of any claim
			 must be resolved by the authorized agency or authorized provider within 12
			 months of the date of service. Claims older than 12 months submitted by the
			 agency or provider to the RH Program shall not be paid, except when the RH
			 Program has made an error that caused the agency or provider not to be able to
			 bill within 12 months of the date of service. The error must be confirmed by
			 the RH Program before the claim shall be paid.
(4) Authorized agencies or authorized
			 providers may void claims at any time after the date of service.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4080 - Payment for Abortion Access Plan Claims

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The RH Program shall make payments to an
			 authorized agency or authorized provider that actually performs the services
			 for clients.
(2) Reimbursement
			 rates for abortion services are set by the RH Program. Claims are reimbursed at
			 the rates in effect on the date of service.
(3) The RH Program will not make payment on
			 claims that have been assigned, sold, or otherwise transferred. This includes,
			 but is not limited to, transfer to a collection agency or party who advances
			 money to an agency for accounts receivable.
(4) The RH Program shall only pay for
			 services that are adequately documented and for drug, device, and supply costs
			 that are supported by invoice.
Statutory/Other Authority: ORS
				  413.042 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Statutes/Other Implemented: ORS
				  413.032 & OL 2022, Ch. 435
				  (HB 4034, Section 10)
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4090 - Review or Audit of Abortion Access Plan Claims

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A RH Program staff person, contractor, or
			 auditor may review a claim for assurance that:
(a) Specific medical services, drugs,
			 devices, or supplies were provided to clients by an authorized agency or
			 authorized provider in accordance with OAR 333-004-4040  (Client Eligibility);
			 and
(b) The services, drugs,
			 devices, or supplies were provided in accordance with Abortion Access Plan
			 rules.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4100 - Claim Re-Determination

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If an
			 authorized agency or authorized provider disagrees with an initial claim
			 determination, it may request a review for re-determination of the denied claim
			 payment. The request to open an initial claim determination for a
			 re-determination review must be made to the RH Program in writing, within 60
			 calendar days from the date of the original claim adjudication date.
(2) All requests must contain a detailed
			 letter of explanation identifying the specific re-determination denial issue
			 and alleged error. This information must be submitted to the RH Program at the
			 time of the request.
(3) At the
			 time the request for re-determination is made an authorized agency or
			 authorized provider is responsible for providing the information needed to
			 adjudicate its claim, including relevant health records The RH Program may
			 request additional information that it finds relevant to the review. An
			 authorized agency or authorized provider requesting a re-determination review
			 must include the following:
(a) The specific
			 service, supply or item being denied and a detailed justification for the
			 re-determination of the denied service;
(b) A copy of the original claim and a copy
			 of the original denial notice or remittance advice that describes the basis for
			 the claim denial under re-determination; and
(c) Any information or medical documentation
			 pertinent to support the request and to obtain a resolution of the
			 re-determination review dispute.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4110 - Recovery of Abortion Access Plan Overpayments Resulting from Review or Audit

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When the RH
			 Program determines that an overpayment has been made to an authorized agency or
			 authorized provider, the amount of overpayment is subject to recovery.
(a) If the RH Program determines by the
			 random sampling method set forth in OAR 333-004-4090  (Review or Audit of
			 Abortion Access Plan Claims) that there has been an overpayment, an authorized
			 agency or authorized provider may request a 100 percent audit of all billings
			 submitted to the RH Program for abortion services provided during the period in
			 question.
(b) If an authorized
			 agency or authorized provider requests a 100 percent audit:
(A) The authorized agency or authorized
			 provider is responsible for payment and arrangement; and
(B) The audit must be conducted by a
			 certified public accountant who is knowledgeable with the Oregon Administrative
			 Rules covering the payments in question and must be conducted within 60
			 calendar days of the request to use such audit in lieu of the RH Program's
			 random sample.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4120 - Grounds for Sanctions; Sanctions

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 The following may result in the imposition of a sanction against an authorized
			 agency or authorized provider:
(a)
			 Interference with the investigation of health care fraud;
(b) Conviction for unlawfully manufacturing,
			 distributing, prescribing, or dispensing a controlled substance;
(c) An action by a state licensing authority
			 relating to a provider's professional competence, professional conduct, or
			 financial integrity, that results in the provider either:
(A) Having their license suspended or
			 revoked; or
(B) Surrendering the
			 license while a formal disciplinary proceeding was pending before a licensing
			 authority.
(d)
			 Suspension or exclusion from participation in a federal or state-administered
			 health care program for reasons related to professional competence,
			 professional performance, or other reason;
(e) Threatening, intimidating, or harassing
			 clients or their relatives;
(f)
			 Participation in collusion that resulted in an inappropriate money flow between
			 the parties involved, for example, referring clients unnecessarily to another
			 provider;
(g) Submittal of
			 fraudulent claims;
(h) Unauthorized
			 or unlawful disclosure of client information; or
(i) Failure to comply with OAR 333-004-4000  through 333-004-4130.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 4 - OREGON REPRODUCTIVE HEALTH PROGRAM › Section 333-004-4130 - Requests for Reconsideration

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An
			 authorized agency or authorized provider may request reconsideration of a RH
			 Program decision that directly adversely affects the agency or provider such
			 as:
(a) A denial or limitation of payment
			 allowed for services or items provided.
(b) A RH Program overpayment determination
			 made under OAR 333-004-4110  (Recovery of RH Access Fund Overpayments Resulting
			 from Review or Audit).
(c) A
			 sanction.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0000 - Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The purpose of
			 these rules is to establish requirements for a voluntary statewide program for
			 providing newborn nurse home visiting services to all families with newborns
			 residing in the state to support healthy child development and strengthen
			 families.
(2) Newborn nurse home
			 visiting services provided under these rules must be reimbursed by health
			 benefit plans as specified in ORS 743A.078.
Statutory/Other Authority: ORS
				  413.042 & ORS
				  433.301
Statutes/Other Implemented: ORS
				  433.301
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0020 - Community Lead Designation

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 Authority shall designate one community lead per community.
(a) Communities based on geographic areas,
			 including counties, shall have one community lead;
(b) Communities may be based on tribal
			 membership and coexist with a community lead designated for the geographic area
			 where the tribal member lives.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0030 - Community Lead Application Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) If a community lead applicant satisfies
			 these rules, the Authority may designate the applicant as the community lead.
			 The Authority shall notify the applicant in writing of the
			 designation.
(2) The Authority may
			 deny designation to an applicant as the community lead if:
(a) A community lead for the identified
			 community is already designated;
(b) The applicant fails to submit a complete
			 application or required documentation;
(c) The applicant fails to demonstrate that
			 it shall comply with the requirements of these rules or has a history of
			 noncompliance with the requirements of these rules; or
(d) The applicant submits false or misleading
			 information.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0040 - Community Lead Renewal and Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A community lead may apply to renew its
			 designation by submitting a complete renewal application to the Authority in
			 the format provided by the Authority at least 60 days prior to the expiration
			 of its current designation.
(2) The
			 Authority may deny renewal of a designation if:
(a) The applicant fails to timely submit a
			 complete application or required documentation;
(b) A letter of support is required and is
			 withdrawn; or
(c) The applicant
			 fails to comply with the requirements of these rules or has a history of
			 noncompliance with the requirements of these rules.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0050 - Community Lead Services Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Community leads must:
(a) Implement a universally offered newborn
			 nurse home visiting services model that has been reviewed by the Administration
			 for Children and Families to meet the HHS criteria for an evidence-based early
			 childhood home visiting service delivery model.
(b) Coordinate with all certified providers
			 in its identified community so that all families with newborns are contacted no
			 later than two weeks after birth of the newborn and offered services.
(c) Develop and implement strategies in
			 collaboration with the Authority to obtain funding to facilitate the provision
			 of newborn nurse home visiting services.
(d) Collaborate with other home visiting
			 providers to integrate newborn nurse home visiting services into the existing
			 services for families in the identified community so that a coordinated system
			 of support is in place.
(e)
			 Maintain a written plan describing how the community lead will comply with
			 subsections (a) through (d) of this section.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0060 - Community Lead Training Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Community leads must ensure staff members
			 working with the Newborn Nurse Home Visiting Program receive an orientation
			 within six weeks of beginning work in the program that includes, but is not
			 limited to:
(a) Overview of the home visiting
			 model implemented by the community lead described in OAR
			 333-006-0050(1)(a);
(b) Training in
			 early childhood systems coordination that includes stakeholder engagement,
			 working with community advisory boards, identification of community resources
			 and using data;
(c) Training in
			 adverse childhood experiences and resilience.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0070 - Newborn Nurse Home Visiting Provider Certification

Current through Register Vol. 63, No. 7, July 1, 2024
(1) To apply for certification as a newborn
			 nurse home visiting provider, an applicant must:
(a) Submit a complete application, in a
			 format prescribed by the Authority;
(b) Submit documentation demonstrating that
			 the applicant meets the requirements of these rules, including but not limited
			 to providing the following:
(A) Letter of
			 support from the community lead designated for the applicant's identified
			 community; and
(B) Copies of the
			 policies and procedures required in OAR 333-006-0110.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0080 - Newborn Nurse Home Visiting Provider Application Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority
			 shall review the application to determine if it is complete. If the applicant
			 does not provide all of the documentation and information required in OAR
			 333-006-0070, the Authority shall reject the application as
			 incomplete.
(2) If the applicant
			 meets all of the certification requirements, the Authority may:
(a) Issue the applicant a written certificate
			 that includes the identified community(ies); and
(b) Schedule an on-site review in accordance
			 with OAR 333-006-0140.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0090 - Newborn Nurse Home Visiting Provider Certification Renewal

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A certified
			 provider may apply to renew its certification by submitting a complete renewal
			 application to the Authority in the format provided by the Authority.
(2) A renewal application shall include the
			 following:
(a) Attestation that the certified
			 provider continues to implement the home visiting model described in OAR
			 333-006-0050(1)(a); and
(b)
			 Attestation that the community lead's letter of support for the certified
			 provider has not been withdrawn.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0100 - Newborn Nurse Home Visiting Provider Coordination

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Certified providers must coordinate with
			 the community lead(s) designated in the communities that the certified provider
			 serves, or the Authority if no community lead has been designated. Coordination
			 includes, but is not limited to:
(a) Actively
			 communicating and working with community leads to ensure that the services are
			 offered to all families with newborns residing in the community lead's
			 identified community.
(b)
			 Participating in community lead's community advisory board.
(c) Actively communicating and collaborating
			 with other home visiting providers in the identified communities to promote
			 continuity of care.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0110 - Newborn Nurse Home Visiting Provider Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Certified providers must:
(a) Provide home visiting services that meet
			 the requirements for the universally offered newborn nurse home visiting model
			 implemented by the community lead in the provider's identified
			 community.
(b) Provide visits and
			 services that meet the requirements for newborn nurse home visiting in OAR
			 333-006-0120.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0120 - Newborn Nurse Home Visiting Service Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Certified providers must timely offer the
			 home visiting services described in this rule to families with
			 newborns.
(2) Certified providers
			 must timely provide the home visiting services as described in this rule
			 unless:
(a) The family requests that the
			 services be provided at another time and the provider documents the request in
			 the client's medical record; or
(b)
			 The family refuses or elects not to participate in a specific service and the
			 provider documents the refusal in the client's medical
			 record.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0130 - Newborn Nurse Home Visitor Provider Training Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Certified
			 providers shall ensure that staff working in the program timely receive the
			 training in this rule.
(2) All
			 staff working in the program must receive training that includes an overview of
			 the universally offered newborn nurse home visiting model implemented by the
			 community lead in the certified provider's identified community prior to
			 providing services.
(3) All staff
			 working in the program must receive the following training prior to providing
			 services and annually thereafter:
(a)
			 Culturally and linguistic responsiveness and implicit bias;
(b) Child abuse and vulnerable adult
			 mandatory reporting; and
(c) Other
			 training as required by the Authority.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0140 - Newborn Nurse Home Visiting Provider Review

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority, or its designee, may
			 conduct a review of each certified newborn nurse home visiting provider within
			 one year of initial certification to determine compliance with these rules. The
			 Authority may conduct additional reviews in its discretion.
(2) The certified provider must permit the
			 Authority, or its designee, access to the certified provider's place of
			 business during a review. The provider must permit the Authority, or its
			 designee, access to provider records and cooperate with the Authority during a
			 review. A review may include, but is not limited to:
(a) Review of documents, policies and
			 procedures, and records;
(b) Review
			 of electronic health records systems, and review of practice management
			 systems;
(c) Review of data reports
			 from electronic systems or other tracking systems; and
(d) Interviews with management, clinical and
			 administrative staff.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0150 - Newborn Nurse Home Visiting Provider Compliance

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A certified provider must notify the
			 community lead(s) and the Authority within 20 calendar days of any change that
			 brings the provider out of compliance with these rules.
(2) The Authority may revoke, deny renewal,
			 or suspend a certificate for a certified provider if:
(a) The certified provider submits false,
			 misleading, or incorrect information;
(b) The certified provider violates ORS
			 433.301 or these rules;
(c) The
			 certified provider fails to cooperate with a review or request for
			 documentation;
(d) The certified
			 provider fails to timely complete corrective actions;
(e) The community lead withdraws its letter
			 of support for the certified provider; or
(f) The certified provider poses a danger to
			 public health or safety.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0160 - Health Benefit Plans Reporting Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
For each calendar year,carriers shall report the following
				de-identified information to the Authority on an annual basis:
(1) Number of enrollees who added a newborn
			 to coverage under the carrier's health benefit plans;
(2) Number of enrollees reported under
			 section (1) who, at the time the newborn was added to coverage, resided in an
			 identified community where a certified provider was authorized to provide
			 services;
(3) Number of enrollees
			 for whom the carrier paid claims for services from a certified
			 provider;
(4) Number of enrollees
			 for whom the carrier paid claims for services from a certified provider on
			 multiple dates of service; and
(5)
			 Any other claims data for services from a certified provider requested by the
			 Authority.
Statutory/Other Authority: ORS
				  413.042, ORS
				  433.301  & ORS
				  743A.078
Statutes/Other Implemented: ORS
				  433.301  & ORS
				  743A.078
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0170

Current through Register Vol. 63, No. 7, July 1, 2024
Statutory/Other Authority: ORS
				  413.042, ORS
				  433.301  & ORS
				  743A.078
Statutes/Other Implemented: ORS
				  433.301  & ORS
				  743A.078
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0180 - Health Benefit Plan Reimbursement Requirements

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As used in OAR
			 333-006-0180  through 333-006-0190  the following definitions apply:
(a) "Billing guidance" means a document
			 describing the claim submission process.
(b) "Budget standards" means a document
			 describing standardized and allowable expenses included in the determination of
			 the case rate for newborn nurse home visiting services, including Community
			 Lead Service Requirements outlined in OAR 333-006-0050  and Newborn Nurse Home
			 Visiting Provider and Service Requirements outlined in OAR 333-006-0100  through
			 333-006-0130.
(c) "Case rate" means
			 a flat fee paid for newborn nurse home visiting services. The case rate
			 includes all newborn nurse home visiting services, including Community Lead
			 Service Requirements outlined in OAR 333-006-0050  and Newborn Nurse Home
			 Visiting Provider and Service Requirements outlined in OAR 333-006-0100  through
			 333-006-0130. The case rate is also known as a bundled claim.
(d) "Single support visit rate" means a
			 one-time flat fee paid when a support visit, as defined in OAR
			 333-006-0010(16), is completed prior to a comprehensive newborn nurse home
			 visit and the comprehensive newborn nurse home visit is subsequently not
			 completed.
(e) "Template" means the
			 document the Authority shall provide to each newborn nurse home visiting
			 provider and community lead in order to document costs related to providing
			 newborn nurse home visiting services. The template will reflect the budget
			 standards.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 6 - UNIVERSALLY OFFERED NEWBORN NURSE HOME VISITING PROGRAM › Section 333-006-0190 - Reimbursement Methodology

Current through Register Vol. 63, No. 7, July 1, 2024
The health benefit plan reimbursement methodology for newborn
				nurse home visiting services is a claim invoicing process.
(1) If a health benefit plan requires
			 credentialing as a prerequisite to claim submission, health benefit plans must
			 credential Authority-certified newborn nurse home visiting providers. Newborn
			 nurse home visiting providers must be credentialed as an organization. The
			 organization also serves as the rendering provider.
(2) A bundled claim submitted for the newborn
			 nurse home visiting services case rate must include, at a minimum, a
			 comprehensive newborn nurse home visit, meeting the requirements of OAR
			 333-006-0120(5) and (6). The bundled claim may include one to two support
			 visits that occur after the comprehensive visit and may include one support
			 visit that occurs prior to a comprehensive visit.
(a) If a support visit is completed prior to
			 a comprehensive newborn nurse home visit and the comprehensive newborn nurse
			 home visit is subsequently not completed, the newborn nurse home visiting
			 provider must submit a claim for the single support visit rate.
(b) Claims must follow the Authority's
			 billing guidance for newborn nurse home visiting services and generally
			 accepted medical services billing standards.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0210

Current through Register Vol. 63, No. 7, July 1, 2024
Tables referenced are not included in rule text.
Click
				  here for PDF copy of
				  table(s)
Stat. Auth.: ORS
				  475B.625
Stats. Implemented: ORS
				  475B.625
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0220

Current through Register Vol. 63, No. 7, July 1, 2024
Tables referenced are not included in rule text.
Click
				  here for PDF copy of
				  table(s)
Stat. Auth.: ORS
				  475B.625
Stats. Implemented: ORS
				  475B.625
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0300 - Cannabis Testing: Purpose

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The
			 purpose of these rules is to establish the minimum compliance testing standards
			 for marijuana items and industrial hemp-derived vapor items. These rules are
			 applicable to persons who process, sell, or transfer marijuana items or
			 industrial hemp-derived vapor items except as exempted in section (2) of this
			 rule.
(2) The testing requirements
			 do not apply to:
(a) A grower if the person is
			 transferring usable marijuana or an immature marijuana plant to:
(A) A patient who designated the grower to
			 grow marijuana for the patient; or
(B) A designated primary caregiver or an
			 organization or facility caregiver of the patient who designated the grower to
			 grow marijuana for the patient; or
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0310 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
For purposes of OAR 333-007-0300  through 333-007-0500:
(1) "Added substance" means any component or
			 ingredient added to usable marijuana, cannabinoid concentrate or cannabinoid
			 extract during or after processing that is present in the finished cannabinoid
			 product, including but not limited to flavors, non-marijuana derived terpenes,
			 and any substances used to change the viscosity or consistency of the
			 cannabinoid product.
(2) "Adult use
			 cannabinoid" includes, but is not limited to, tetrahydrocannabinols,
			 tetrahydrocannabinolic acids that are artificially or naturally derived,
			 delta-8-tetrahydrocannabinol, delta-9-tetrahydrocannabinol, the optical isomers
			 of delta-8-tetrahydrocannabinol or delta-9-tetrahydrocannabinol and any
			 artificially derived cannabinoid that is reasonably determined to have an
			 intoxicating effect.
(3)
(a) "Artificially derived cannabinoid" means
			 a chemical substance that is created by a chemical reaction that changes the
			 molecular structure of any chemical substance derived from the plant Cannabis
			 family Cannabaceae.
(b)
			 "Artificially derived cannabinoid" does not include:
(A) A naturally occurring chemical substance
			 that is separated from the plant Cannabis family Cannabaceae by a chemical or
			 mechanical extraction process;
(B)
			 Cannabinoids that are produced by decarboxylation from a naturally occurring
			 cannabinoid acid without the use of a chemical catalyst; or
(C) Any other chemical substance identified
			 by the Commission, in consultation with the Authority and the Department of
			 Agriculture, by rule.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0315 - Ordering Tests

Current through Register Vol. 63, No. 7, July 1, 2024
(1) To request a
			 compliance test a requestor must provide a laboratory, prior to laboratory
			 taking samples, with at a minimum, the following information as applicable:
(a) The registrant or licensee's registrant
			 or license number.
(b) The name,
			 address and contact information of the registrant or licensee.
(c) If a registrant, whether the registrant
			 is subject to tracking in CTS, under OAR chapter 333, division 8.
(d) Type of marijuana item or industrial
			 hemp-derived vapor item.
(e)
			 Harvest lot number that is associated with the batch numbers, if
			 applicable.
(f) Process lot number
			 that is associated with the batch numbers, if applicable.
(g) Batch numbers to be sampled.
(h) Total mass or volume of each batch to be
			 sampled.
(i) For cannabinoid
			 products, all intended units of sale.
(j) Identification of the test or tests the
			 laboratory is being requested to conduct.
(k) Whether the test or tests being requested
			 are compliance tests.
(l) Whether
			 the test or tests being requested are for quality control, research and
			 development, or any other purpose other than a compliance test.
(m) Whether a batch is being re-sampled
			 because of a failed test, the date the failed test result was received by the
			 registrant or licensee and laboratory identification number of the laboratory
			 that conducted the initial test.
(n) Whether the marijuana item or industrial
			 hemp-derived vapor item was remediated if remediation is permitted under OAR
			 333-007-0450.
(o) If a wholesaler
			 is requesting a test on behalf of another registrant or licensee, the
			 wholesaler must provide in addition to their own license number and name, the
			 registration or license number and name of that registrant or
			 licensee.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0320 - Compliance Testing Requirements for Marijuana or Usable Marijuana

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A producer or
			 grower must test every batch from a harvest lot of marijuana or usable
			 marijuana intended for use by a consumer or patient prior to selling or
			 transferring the marijuana or usable marijuana for the following:
(a) Pesticides in accordance with OAR
			 333-007-0400.
(b) Water activity
			 and moisture content in accordance with OAR 333-007-0420.
(c) Adult use cannabinoid and CBD
			 concentration in accordance with OAR 333-007-0430.
(d) Heavy metals in accordance with OAR
			 333-007-0415  if the marijuana or usable marijuana is or was harvested on or
			 after March 1, 2023.
(e) Mycotoxins
			 in accordance with OAR 333-007-0425  if the marijuana or usable marijuana is or
			 was harvested on or after July 1, 2022.
(f) Microbiological contaminants in
			 accordance with OAR 333-007-0390  if the marijuana or usable marijuana is or was
			 harvested on or after March 1, 2023.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0330 - Compliance Testing Requirements for Cannabinoid Concentrates and Extracts

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A processor or
			 processing site must test every process lot of a finished cannabinoid
			 concentrate or extract for use by a consumer or patient prior to selling or
			 transferring the cannabinoid concentrate or extract for the following:
(a) Pesticides in accordance with OAR
			 333-007-0400.
(b) Solvents in
			 accordance with OAR 333-007-0410.
(c) Adult use cannabinoid and CBD
			 concentration in accordance with OAR 333-007-0430.
(d) Heavy metals in accordance with OAR
			 333-007-0415  if the cannabinoid concentrate or extract is or was manufactured
			 on or after March 1, 2023.
(e)
			 Mycotoxins in accordance with OAR 333-007-0425  if the cannabinoid concentrate
			 or extract is or was manufactured on or after July 1, 2022.
(f) Microbiological contaminants in
			 accordance with OAR 333-007-0390  if the cannabinoid concentrate or extract is
			 or was manufactured on or after March 1, 2023.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 7 - MARIJUANA AND HEMP TESTING › Section 333-007-0340 - Compliance Testing Requirements for Cannabinoid Products

Current through Register Vol. 63, No. 7, July 1, 2024
(1) A processor or processing site must test
			 every process lot of a finished cannabinoid product intended for human
			 consumption, use or ingestion for use by a consumer or patient prior to selling
			 or transferring the cannabinoid product for adult use cannabinoid and CBD
			 concentration in accordance with OAR 333-007-0430.
(2) A processor or processing site must test
			 a process lot of a finished cannabinoid product intended for human consumption,
			 use or ingestion for microbiological contaminants in accordance with OAR
			 333-007-0390, upon written request by the Authority or the
			 Commission.
(3) In lieu of ordering
			 and arranging for the sampling and testing required in this rule a processor
			 may transport batches of cannabinoid products referenced in section (1) of this
			 rule to a wholesaler licensed by the Commission under ORS 475C.093 and the
			 wholesaler may order and arrange for the sampling and testing of the batches,
			 in accordance with rules established by the Commission.
Statutory/Other Authority: ORS 475C.544
Statutes/Other Implemented: ORS
				  475C.544