reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 8 - MEDICAL MARIJUANA › Section 333-008-3010 - Medical Marijuana Records: System to Allow Verification of Data at All Times By State and Local Law Enforcement

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Authority shall establish an
			 interactive method to allow authorized employees of state and local law
			 enforcement agencies to use the Oregon State Police Law Enforcement Data System
			 (LEDS) to query an OMMP data file in order to verify at any time whether a
			 particular patient, designated primary caregiver, or grow site location is
			 listed or registered with the Authority.
(2) LEDS access will only allow a yes or no
			 answer to the query and the information obtained may not be used for any other
			 purpose other than verification.
(3) The Authority may allow the release of
			 reports related to verification if it is without identifying data.
(4) The Authority shall have staff available
			 by phone to verify law enforcement agency employee questions during regular
			 business hours in case the electronic verification system is down, and in the
			 event the system is expected to be down for more than two business days, the
			 Authority shall ensure program staff are available by phone for verification
			 purposes.
Statutory/Other Authority: ORS 475C.859 & 475C.919
Statutes/Other Implemented: ORS
				  475C.859
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 8 - MEDICAL MARIJUANA › Section 333-008-9900

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS
				  475B.415,
				  475B.420,
				  475B.525
Stats. Implemented: ORS
				  475B.415
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 8 - MEDICAL MARIJUANA › Section 333-008-9905

Current through Register Vol. 63, No. 7, July 1, 2024
Statutory/Other Authority: ORS
				  475B.797,
				  475B.804,
				  475B.810,
				  475B.949,
				  Governor's Executive Order 20- 03, Governor's Executive Order 20-12, Governor's
				  Executive Order 20-27, Governor's Executive Order 20-59
Statutes/Other Implemented: ORS
				  475B.797,
				  475B.804,
				  475B.810,
				  475B.949,
				  Governor's Executive Order 20- 03, Governor's Executive Order 20-12, Governor's
				  Executive Order 20-27, Governor's Executive Order
				  20-59
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 9 - REPORTING REQUIREMENTS OF THE OREGON DEATH WITH DIGNITY ACT › Section 333-009-0000 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
For the purpose of OAR 333-009-0000  through 333-009-0030, the
				following definitions apply.
(1) "Act"
			 means the "Oregon Death with Dignity Act" or Measure 16 as adopted by the
			 voters on November 8, 1994.
(2)
			 "Adult" means an individual who is 18 years of age or older.
(3) "Attending physician" means the physician
			 who has primary responsibility for the care of the patient and treatment of the
			 patient's terminal disease.
(4)
			 "Authority" means the Oregon Health Authority.
(5) "Capable" means that in the opinion of a
			 court or in the opinion of the patient's attending physician or consulting
			 physician, psychiatrist or psychologist, a patient has the ability to make and
			 communicate health care decisions to health care providers, including
			 communication through persons familiar with the patient's manner of
			 communicating, if those persons are available.
(6) "Consulting physician" means a physician
			 who is qualified by specialty or experience to make a professional diagnosis
			 and prognosis regarding the patient's disease.
(7) "Counseling" means one or more
			 consultations as necessary between a state licensed psychiatrist or
			 psychologist and a patient for the purpose of determining that the patient is
			 capable and not suffering from a psychiatric or psychological disorder or
			 depression causing impaired judgment.
(8) "Dispensing record" means a copy of the
			 pharmacy dispensing record form.
(9) "Health care facility" shall have the
			 meaning given in ORS 442.015.
(10) "Health care provider" means a person
			 licensed, certified or otherwise authorized or permitted by the law of this
			 state to administer health care or dispense medication in the ordinary course
			 of business or practice of a profession and includes a health care
			 facility.
(11) "Patient" means a
			 person who is under the care of a physician.
(12) "Physician" means a doctor of medicine
			 or osteopathy licensed to practice medicine by the Oregon Medical
			 Board.
(13) "Qualified patient"
			 means a capable adult who has satisfied the requirements of this Act in order
			 to obtain a prescription for medication to end their life in a humane and
			 dignified manner.
Statutory/Other Authority: ORS
				  127.865
Statutes/Other Implemented: ORS
				  127.800-127.995
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 9 - REPORTING REQUIREMENTS OF THE OREGON DEATH WITH DIGNITY ACT › Section 333-009-0010 - Reporting

Current through Register Vol. 63, No. 7, July 1, 2024
(1) To comply with
			 ORS 127.865(2),
			 within seven calendar days of writing a prescription for medication to end the
			 life of a qualified patient the attending physician shall send the following
			 completed, signed and dated documentation by regular mail to the State
			 Registrar, Center for Health Statistics, 800 NE Oregon Street, Suite 205,
			 Portland OR 97232, by facsimile to (971) 673-5332, or by secure electronic
			 mail:
(a) The patient's completed written
			 request for medication to end life, either using the "Written Request for
			 Medication to End My Life in a Humane and Dignified Manner" form prescribed by
			 the Oregon Health Authority (Authority) or in substantially the form described
			 in ORS 127.897;
(b) One of the following reports prescribed
			 by the Authority:
(A) "Attending Physician's
			 Compliance Form"; or
(B) "Attending
			 Physician's Compliance Short Form" accompanied by a copy of the relevant
			 portions of the patient's medical record documenting all actions required by
			 the Act;
(c) "Consulting
			 Physician's Compliance Form" prescribed by the Authority; and
(d) "Psychiatric/Psychological Consultant's
			 Compliance Form" prescribed by the Authority, if an evaluation was
			 performed.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 9 - REPORTING REQUIREMENTS OF THE OREGON DEATH WITH DIGNITY ACT › Section 333-009-0020 - Record Review/Annual Report

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 The Authority shall annually review records maintained pursuant to this
			 Act.
(2) The Authority shall
			 generate and make available to the public an annual statistical report of
			 information collected under this Act.
Stat. Auth.: ORS 127.800
Stats. Implemented: ORS 127.800 -
				  127.897
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 9 - REPORTING REQUIREMENTS OF THE OREGON DEATH WITH DIGNITY ACT › Section 333-009-0030 - Confidentiality/Liability

Current through Register Vol. 63, No. 7, July 1, 2024
(1) All information
			 collected pursuant to ORS 127.800 to 127.897 including, but not limited to, the
			 identity of patients, physicians and other health care providers, and health
			 care facilities shall not be a public record and may not be made available for
			 inspection by the public.
(2) All
			 information collected pursuant to ORS 127.800 to 127.897 and the annual
			 statistical report referred to in
			 333-009-0020(2)
 
			 shall be considered a special morbidity and mortality study under ORS 432.060.
			 Summary information released in statistical reports shall be aggregated to
			 prevent identification of individuals, physicians, or health care
			 facilities.
(3) Pursuant to ORS
			 432.060, providing morbidity and mortality information to the Authority does
			 not subject any physician, hospital, health care facility or other organization
			 or person furnishing such information to an action for damages.
(4) Access to death certificate information
			 shall be in accordance with OAR
			 333-011-0096  pursuant to
			 ORS 432.121.
Stat. Auth.: ORS 127.800
Stats. Implemented: ORS 127.800 - 127.995, 432.060,
				  432.121
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0030 - Cancer Reporting Regulations: Reporting Requirements for Practitioners

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any
			 practitioner diagnosing a case of reportable cancer or a reportable
			 non-malignant condition, as defined in OAR 333-001-0000(16) and
			 333-010-0000(18)  respectively, must notify OSCaR of each such case within 180
			 days of the diagnosis of the case. OSCaR will make lists of reportable cancers
			 and reportable non-malignant conditions available on the Oregon State Cancer
			 Registry website:
www.healthoregon.org/oscar
.
(2) Data items required for reporting a case
			 of reportable cancer or reportable non-malignant condition shall include, but
			 not be limited to, cancer diagnosis and treatment information, patient
			 demographics, and practitioner contact information, as specified on the Central
			 Cancer Registry Notification Form. Copies of the Central Cancer Registry
			 Notification Form will be available on the Oregon State Cancer Registry
			 website:
www.healthoregon.org/oscar
.
(3) Practitioners must comply with one of the
			 following optional notification methods as may be directed by OSCaR:
(a) Completion and submission (by mail or
			 facsimile) of the Central Cancer Registry Notification Form; or
(b) An encrypted electronic communication
			 directed to OSCaR containing the information required by the Central Cancer
			 Registry Notification Form.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0032 - Cancer Reporting Regulations: Reporting Requirements for Clinical Laboratories

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Clinical
			 laboratories must report to OSCaR all cases with test results indicative of and
			 specific for a reportable cancer or reportable non-malignant condition, as
			 defined in OAR 333-010-0000(16)  and 333-010-0000(18)  respectively, ("Cancer
			 Pathology Reports") in accordance with the following provisions. Clinical
			 laboratories must submit all Cancer Pathology Reports to OSCaR using the
			 electronic data exchange format and codes set forth in the guidelines for
			 Pathology Laboratory Electronic Reporting issued by the North American
			 Association of Central Cancer Registries ("NAACCR"), unless reported to a
			 health system cancer registry. The NAACCR Guidelines for Pathology Laboratory
			 Electronic Reporting are available from OSCaR.
(2) Clinical laboratories must also report to
			 OSCaR all cases with biopsies (excluding cytologic tests) indicative of and
			 specific for a reportable pre-malignant condition, as defined in OAR
			 333-010-0000(16), in an electronic format directed by OSCaR. These reports must
			 include (if available to the clinical laboratory):
(a) Name, address, and telephone number of
			 the physician listed on the lab order;
(b) Name, address, and telephone number of
			 the reporting laboratory;
(c)
			 Patient name, gender, address (if available), birth date,
			 race/ethnicity;
(d) Primary site
			 and type of cancer-related condition; and
(e) Date of diagnosis.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0035 - Patient Notification Requirement

Current through Register Vol. 63, No. 7, July 1, 2024
This rule describes the process for notifying patients that
				information about a reportable cancer has been reported to OSCaR.
(1) OSCaR may, but is not required to notify
			 patients that information about a diagnosis of reportable cancer has been
			 included in the registry. OSCaR may make a determination, based on budgeting
			 constraints or otherwise, to curtail patient notification activities.
(2) Information to be provided to patients.
			 The notification to the patient shall include the following information about
			 the purposes of the registry and the protection of confidentiality:
(a) That Oregon statute requires that every
			 cancer newly diagnosed in Oregon, or in an Oregon resident, be reported to the
			 Oregon State Cancer Registry maintained by the Oregon Health
			 Authority;
(b) That information
			 reported to the Authority includes the type and characteristics of the cancer,
			 details of the diagnosis and treatment given, and patient demographic
			 information;
(c) That the
			 information is used to understand how cancer affects the population in Oregon,
			 to design and implement prevention and control programs, and for
			 research;
(d) That the information
			 is confidential and no identifiable information about the patient can be
			 released to anyone unless very strict requirements, as provided by law, are
			 met;
(e) If those specific
			 requirements, as provided by law, are met, researchers may be allowed to
			 contact patients to offer them the opportunity to participate in research
			 projects. Any invitation to participate in research is always voluntary and may
			 be freely declined; and
(f) That
			 the researcher shall first notify the patient's physician regarding the
			 patient's participation in a research project, unless the patient specifies to
			 OSCaR that their name never be released for any research purpose.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0040 - Cancer Reporting Regulations: Quality Standards

Current through Register Vol. 63, No. 7, July 1, 2024
The usefulness of OSCaR data is directly dependent upon the
				accuracy, completeness, and timeliness of the data available in its database.
				ORS
				432.510 directs the Oregon Health Authority to establish a quality control system for
				the data reported to the state registry. In order to assess these aspects of
				quality for cancer reporting, the central cancer registry will institute a
				program of continuous quality improvement.
(1) The continuous quality control system
			 must include, but is not limited to, assessing coding edits, completeness
			 audits or checks, reabstracting audits, and data analysis techniques to
			 estimate data accuracy, validity, and reliability. OSCaR may provide training
			 and corrective measures to improve data accuracy, validity, and
			 reliability.
(2) For the purpose of
			 assuring the accuracy and completeness of reported data:
(a) OSCaR shall have the right to
			 periodically review all records that would identify cases of reportable cancer
			 and reportable non-malignant conditions or would establish characteristics of
			 the cancer, treatment of the cancer or the medical status of any identified
			 cancer patient. OSCaR will provide advance notification of a minimum of 30
			 days, to allow time for the reporting sources to prepare records for
			 review.
(b) When a patient has been
			 seen for care or diagnosis by multiple reporting facilities, practitioners, or
			 clinical laboratories, OSCaR may communicate with the reporting facilities,
			 providers and laboratories to evaluate the accuracy of data reported. OSCaR may
			 disclose confidential cancer data to a health care facility, practitioner, or
			 laboratory to correct, complete, or improve the accuracy of the reported
			 data.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0050 - Cancer Reporting Regulations: Confidentiality and Access to Data

Current through Register Vol. 63, No. 7, July 1, 2024
This rule describes when confidential and privileged
				information collected and maintained by OSCaR may be shared and the process for
				obtaining aggregate non-confidential OSCaR information that is not publically
				available.
(1) All identifying
			 information regarding individual patients, health care facilities, clinical
			 laboratories, and practitioners reported pursuant to ORS
			 432.510 and
			 432.520,
			 OAR 333-010-0020, 333-010-0030  and 333-010-0032  shall be confidential and
			 privileged. Except as required in connection with the administration or
			 enforcement of public health laws or rules, no public health official,
			 employee, or agent shall be examined in an administrative or judicial
			 proceeding as to the existence or contents of data collected under the cancer
			 registry system.
(2) The
			 information collected and maintained by OSCaR must be stored in secure
			 locations, must be used solely for the purposes stated in ORS
			 432.510 and
			 432.520 and must not be further disclosed unless required by law, with the following
			 exceptions:
(a) When OSCaR has entered into
			 reciprocal cooperative agreements with other states to exchange information on
			 resident cases, as provided for in ORS
			 432.540.
			 Such agreements must provide for obtaining data on Oregon resident cases
			 diagnosed or treated out of state, and for reciprocal rights of other states to
			 receive information on residents of those states diagnosed or treated in
			 Oregon. Before entering into an agreement with any other state, OSCaR must
			 determine that the other state has comparable confidentiality
			 protections;
(b) When disclosure to
			 officers or employees of federal, state, or local government public health
			 agencies is necessary to investigate or avoid a clear and immediate danger to
			 other individuals or to the public generally;
(c) When the Authority elects to contract
			 with another agency for performance of a registry function the Authority will
			 require the contractor to agree to use the information only for the purposes of
			 the central cancer registry, to maintain the information securely, and to
			 protect the information from unauthorized disclosure as referred to in OAR
			 333-010-0050(1). Before entering into any contract with another agency the
			 Authority must determine the agency has comparable confidentiality protections;
			 and
(d) When the Authority deems
			 that the information is necessary for others to conduct research in conformance
			 with the purposes for which the data are collected.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0055 - Cancer Reporting Regulations: Research Studies

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Requirements for Research Studies. Before
			 any confidential data may be disclosed to a researcher, OSCaR must:
(a) Approve a submitted protocol for the
			 proposed research, which describes how the research will be used to determine
			 the sources of cancer among the residents of Oregon or to reduce the burden of
			 cancer in Oregon, in accordance with ORS
			 432.510 and OAR 333-010-0010;
(b) Agree
			 that the data requested are necessary for the effective and efficient conduct
			 of the study;
(c) Approve the
			 researcher's submitted protocol and procedures for:
(A) Identifying patients to be
			 contacted;
(B) Protecting against
			 inadvertent disclosure of confidential and privileged data;
(C) Providing secure conditions to use and
			 store the data;
(D) Assuring that
			 the data will only be used for the purposes of the study; and
(E) Assuring that confidential and privileged
			 data will be destroyed upon conclusion of the research;
(d) Determine that the researcher has access
			 to sufficient resources to carry out the proposed research before releasing any
			 confidential data;
(e) Confirm
			 appropriate review of the research, including peer review for scientific merit,
			 and review by the body used by the Authority as the Committee for the
			 Protection of Human Research Subjects and established in accordance with  45
			 C.F.R. 46 :
(A) A researcher's proposed study
			 must comply with the requirements of the Federal Policy for the Protection of
			 Human Subjects codified at  45 C.F.R. 46  as a condition of receiving
			 confidential information from OSCaR.
(B) The Committee must evaluate studies under
			  45 C.F.R. Part 46 's requirements for disclosure and must approve the study
			 prior to OSCaR releasing any data.
(f) Determine the need for and require the
			 researcher to implement other safeguards which, in the judgment of OSCaR, may
			 be necessary for protecting confidential and privileged data from inadvertent
			 disclosure due to unique or special characteristics of the proposed
			 research.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0060 - Cancer Reporting Regulations: Special Studies

Current through Register Vol. 63, No. 7, July 1, 2024
(1) From time to time, OSCaR may elect to
			 conduct special studies of cancer mortality, morbidity, treatment options and
			 cancer control. OSCaR is specifically authorized to obtain any information
			 which may apply to a patient's reportable cancer or reportable non-malignant
			 condition, and which may be found in the medical record of the patient under
			 ORS
			 432.510 and
			 432.520.
			 Upon request, the practitioner or health care facility must provide the
			 requested information to OSCaR or provide OSCaR personnel access to the
			 relevant portions of the medical records. Neither OSCaR nor the record holder
			 shall bill the other for the cost of providing or obtaining this
			 information.
(2) If, in the conduct
			 of a special study, OSCaR identifies a need for access to pathological
			 specimens that have been collected in connection with a case, OSCaR must make a
			 written request to the clinical laboratory or the health care facility with
			 which the clinical laboratory is affiliated for the purpose of making
			 arrangements for the procurement of such pathological specimens upon mutually
			 agreeable terms.
Statutory/Other Authority: ORS
				  432.510  & 432.520
Statutes/Other Implemented: ORS
				  432.510  & 432.520
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0070 - Advisory Committee

Current through Register Vol. 63, No. 7, July 1, 2024
The Authority shall appoint an advisory committee to review the
				operations of the central registry and to make recommendations regarding
				registry policy, and to review research protocols for which confidential and
				privileged data are requested. The composition of the advisory committee must
				generally represent those with a professional or personal interest in
				cancer.
Stat. Auth.: ORS 432.510, 432.520
Stats. Implemented: ORS
				  432.510
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0080 - Cancer Reporting Regulations: Training and Consultation

Current through Register Vol. 63, No. 7, July 1, 2024
The Authority shall provide annual continuing education for
				interested persons involved in cancer registry reporting. Continuing education
				content must include, but is not limited to, cancer diagnosis and management,
				epidemiology and statistics, and hardware and software registry applications.
				The central cancer registry staff must supplement the continuing education with
				one-on-one consultations to assist health care facilities and practitioners as
				needed in meeting the reporting requirements.
Statutory/Other Authority: ORS
				  432.510
Statutes/Other Implemented: ORS
				  432.510
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0090 - Cancer Reporting Regulations: Fees

Current through Register Vol. 63, No. 7, July 1, 2024
This rule describes the process by which the Authority will
				calculate the cost of providing cancer reporting services to health care
				facilities, practitioners or clinical laboratories. For health care facilities,
				practitioners and clinical laboratories that are not in compliance with cancer
				reporting requirements, the Authority may elect to provide reporting services
				at cost. The Authority may also provide reporting services at the option of a
				health care facility, practitioner or clinical laboratory.
(1) The Authority may charge a fee reasonably
			 calculated to reimburse the Authority for the cost of providing cancer
			 reporting services to health care facilities:
(a) Costs include but are not limited to the
			 services, supplies and time spent in:
(A)
			 Entering the health care facility, including transportation costs;
(B) Obtaining the information, including
			 costs associated with the electronic retrieval of records;
(C) Reporting in conformance with the
			 appropriate format and standards, including costs associated with the retrieval
			 of paper or electronic records;
(D)
			 Computer programming necessary for reporting services;
(E) Consultation with the health care
			 facility on reporting in conformance with the appropriate format and standards;
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0100 - Description of the ScreenWise Breast and Cervical Cancer Program

Current through Register Vol. 63, No. 7, July 1, 2024
The mission of the Oregon ScreenWise Program is to reduce
				breast cancer, cervical cancer, cardiovascular disease and other diseases by
				promoting early detection through screening, risk reduction counseling,
				behavior modification support, and referral to medical treatment. ScreenWise
				includes the Breast and Cervical Cancer Program (ScreenWise BCC), a federal
				screening and early detection program administered by the Oregon Health
				Authority to provide screening and diagnostic services to eligible Oregonians
				statewide. ScreenWise BCC provides coverage for screening and diagnostic
				services to Oregonians with family incomes up to 250 percent of the Federal
				Poverty Level through a contract network of qualified providers. OAR
				333-010-0100  through 333-010-0197  apply only to providers who have an approved
				medical services agreement to provide screening and diagnostic services through
				this program. The program is limited to a finite source of funds which may
				restrict availability of services on an annual basis.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0110 - Client Eligibility

Current through Register Vol. 63, No. 7, July 1, 2024
In order to be eligible for the ScreenWise BCC a client must
				meet the following eligibility criteria:
(1) Have an income based on family size that
			 is at or below 250 percent of the Federal Poverty Level at the time of
			 enrollment; and
(2) Reside or
			 declare an intent to reside in Oregon; and
(3) Have no health insurance or be
			 underinsured; and
(4) Meet one of
			 the following criteria:
(a) Be a woman age 21
			 or over for clinically recommended breast and cervical cancer screening and
			 diagnostic services; or
(b) Be a
			 man of any age who is displaying signs or symptoms that may indicate breast
			 cancer.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0115 - Client Enrollment

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
(a) Clients are determined eligible on a
			 self-declared basis, when they submit a completed and signed ScreenWise BCC
			 enrollment form at the clinic site at the time of service.
(b) Prior to enrolling a client in ScreenWise
			 BCC, providers with access to the Medicaid Management Information System (MMIS)
			 shall check MMIS to verify that applicant is not currently receiving Medicaid.
			 Clients enrolled in Medicaid are ineligible for ScreenWise BCC.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0120 - Covered Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) ScreenWise
			 BCC covers screening and diagnostic services specific to breast and cervical
			 cancer. Contracted providers will only be reimbursed for services related to
			 breast and cervical cancer screening and diagnosis.
(2) Screening and diagnostic services
			 include, but are not limited to:
(a) For
			 breast cancer, both a clinical breast examination and a mammogram;
(b) For cervical cancer, both a pelvic
			 examination and a Pap smear; and
(c) Laboratory tests and medical procedures
			 necessary for detection and diagnosis of breast and cervical cancer.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0125 - Excluded Services

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Services and
			 laboratory tests not directly related to breast and cervical cancer screening
			 and diagnosis are not covered by ScreenWise BCC for any eligible client. If the
			 client accepts financial responsibility for a non-covered service that is
			 received during a visit, payment arrangements are between the provider and the
			 client, per OAR 333-010-0140(5)(a).
(2) No payment will be made for any expense
			 incurred for any of the following services or items:
(a) Treatment for cancer or pre-cancerous
			 conditions; or
(b) Any medical
			 service or laboratory tests whose primary purpose is for a reason other than
			 breast or cervical cancer screening or diagnostic testing.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0130 - Standards of Care for Breast and Cervical Cancer Screening and Diagnostic Services

Current through Register Vol. 63, No. 7, July 1, 2024
Participating ScreenWise BCC providers must agree to provide
				screening and diagnostic services according to the following standards:
(1) Informed Consent. The client's decision
			 to participate in and consent to receive breast and cervical cancer screening
			 and diagnostic services must be voluntary and without bias or coercion.
(a) The informed consent process, provided
			 verbally and supplemented with written materials, must be presented in a
			 language the client understands.
(b) Consent must be obtained from the
			 individual client receiving screening and diagnostic services.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0135 - Provider Enrollment

Current through Register Vol. 63, No. 7, July 1, 2024
(1) This
			 rule applies only to providers participating in ScreenWise BCC through an
			 approved provider agreement with the Center.
(2) An individual or organization must meet
			 applicable licensing or regulatory requirements set forth by federal and state
			 statutes, regulations, and rules to be enrolled and to bill as a provider. In
			 addition, all providers of services within the State of Oregon must have a
			 valid Oregon business license if such a license is a requirement of the state,
			 federal, county or city government to operate a business or to provide
			 services.
(3) An individual or
			 organization that is currently subject to sanctions by the Authority or the
			 federal government is not eligible for enrollment.
(4) A ScreenWise BCC agency number will be
			 issued to an individual or clinic upon:
(a)
			 Completion of the application and submission of the required
			 documents;
(b) The signing of the
			 provider agreement by the provider or person authorized by the provider to bind
			 the organization or individual to comply with these rules;
(c) Verification of licensing or
			 certification; and
(d) Approval of
			 the application by the Center.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0140 - Billing

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Only clinics
			 providing breast and cervical cancer screening and diagnostic services pursuant
			 to an approved medical services agreement, and who have been assigned an agency
			 number may submit claims for ScreenWise BCC services.
(2) All services must be billed by submitting
			 claim information in the method specified by the ScreenWise BCC.
(3) A primary diagnosis code is required on
			 all claims. All billings must be coded with the most current and appropriate
			 International Classification of Diseases, 10th Revision, Clinical Modification
			 (ICD-10-CM), incorporated by reference and the most appropriate Current
			 Procedural Terminology (CPT) codes. Information regarding CPT code lists,
			 including required notice to providers regarding CPT code list revisions, may
			 be found in the provider's Medical Services Agreement. Claims including primary
			 diagnosis codes that are not listed on the approved CPT code list will not be
			 paid without program approval.
(4)
			 The provider must use CLIA certified laboratories for all tests whether done at
			 the clinic site or by an outside clinic.
(5) Enrolled providers with ScreenWise BCC
			 must not seek payment from an eligible client, or from a financially
			 responsible relative or representative of that individual, for any services
			 covered by ScreenWise BCC.
(a) A client may
			 be billed for services that are not covered by ScreenWise BCC. However, the
			 provider must inform the client in advance of receiving the specific service
			 that it is not covered, the estimated cost of the service, and that the client
			 or client's representative is financially responsible for payment for the
			 specific service. Providers must document in writing that the client was
			 provided this information and the client knowingly and voluntarily agreed to be
			 responsible for payment. The client or client's representative must sign the
			 documentation.
(b) Services not
			 covered by ScreenWise BCC are those outside of the scope of standard breast and
			 cervical cancer screening and diagnosis, or those not included in the ICD-10
			 list, incorporated by reference and approved CPT code lists.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0145 - Claims and Data Submission

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 In addition to submitting standard claims information, enrolling providers are
			 required to submit client data in order to receive payment for the claim. The
			 data is used to collect information pertaining to breast and cervical cancer
			 prevention, diagnosis, and treatment and is used by the National Breast and
			 Cervical Cancer Early Detection Program and the ScreenWise BCC primarily to
			 monitor the delivery of services and clinical outcomes of the
			 program.
(2) Although data
			 requirements may require more information than necessary for payment of a
			 specific claim, all related fields must be completed and submitted.
(3) Data requirements for enrolling providers
			 and ancillary providers are as follows:
(a)
			 Enrolling providers must provide required information on client data forms, as
			 defined by the program and posted on the Program website:
www.healthoregon.org/screenwise
.
(b) Ancillary providers must provide results
			 of services to enrolling providers. Ancillary providers are not required to
			 provide data to the ScreenWise BCC directly.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0150 - Timely Submission of Claims and Data

Current through Register Vol. 63, No. 7, July 1, 2024
(1) All claims for services must be submitted
			 within 120 days of the date of service. Claims older than 120 days from the
			 date of service will not be paid, except as provided for in section (2) and (3)
			 of this rule.
(2) If a claim is
			 denied, the claim must be resolved within 120 days of the date of the denial.
			 Claims older than 120 days from the date of denial will not be paid, except as
			 provided for in section (3) of this rule.
(3) When the Center has made an error that
			 caused the provider not to be able to bill within 120 days of the date of
			 service, then the claim may be submitted to the Center. The error must be
			 confirmed by the Center.
(4) Client
			 data not related to payment of the claim may be updated or corrected at any
			 time after the date of service.
(5) Ancillary providers must provide results
			 of services to enrolling providers within 14 calendar days from the date of
			 service.
(6) Enrolling providers
			 must provide the ScreenWise BCC with enrollment and eligibility information
			 immediately or within five calendar days from the date of enrollment. All other
			 data must be submitted within 90 days from the date of enrollment. In the event
			 that a case requires additional diagnostic procedures that exceed 90 days from
			 the date of enrollment, the data must be submitted immediately upon
			 receipt.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0155 - Payment

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Center will
			 make payment only to providers that have a medical services agreement with the
			 ScreenWise BCC and are billing for an eligible client.
(2) The ScreenWise BCC reimbursement amount
			 will be up to the Medicare reimbursement rate for the Portland metropolitan
			 area for ScreenWise BCC approved CPT codes, on a fee-for-service
			 basis.
(3) Federally qualified
			 health centers or rural health centers are not paid at their Prospective
			 Payment System (PPS) rate; they will receive up to the Medicare reimbursement
			 rate for ScreenWise BCC approved CPT codes, on a fee-for-service
			 basis.
(4) Center payments for
			 ScreenWise BCC provider services, unless in error, constitute payment in
			 full.
(5) The Center will not make
			 payment on claims that have been assigned, sold, or otherwise transferred, or
			 on which a provider of billing services receives a percentage of the amount
			 billed or payment authorized. This includes, but is not limited to, transfer to
			 a collection agency or individual who advances money to a provider for accounts
			 receivable.
Stat. Auth.: ORS
				  413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0160 - Requirements for Financial, Clinical and Other Records

Current through Register Vol. 63, No. 7, July 1, 2024
(1) The Center is responsible for analyzing
			 and monitoring the operation of ScreenWise BCC and for auditing and verifying
			 the accuracy and appropriateness of payment, utilization of services, the
			 quality of care, and access to care. The provider shall:
(a) Develop and maintain adequate financial
			 and clinical records and other documentation which supports the services for
			 which payment has been requested. Payment will be made only for services that
			 are adequately documented.
(b) All
			 medical records must document the service provided, primary diagnosis code for
			 the services, the date on which the service was provided, and the individual
			 who provided the services. Patient account and financial records must also
			 include documentation of charges, identify other payment resources pursued,
			 indicate the date and amount of all debit or credit billing actions, and
			 support the appropriateness of the amount billed and paid. The records must be
			 accurate and in sufficient detail to substantiate the data
			 reported.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0165 - Compliance with Federal and State Statutes

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Submission of a claim for medical
			 services or supplies provided to a ScreenWise BCC client shall be deemed a
			 representation by the medical provider to the Center of the medical provider's
			 compliance with the applicable sections of the federal and state statutes
			 referenced in this rule:
(a)  45 CFR Part 84
			  which implements Title V, Section 504 of the Rehabilitation Act of
			 1973;
(b) Title II and Title III of
			 the Americans with Disabilities Act of 1991;
(c) Title VI of the Civil Rights Act of 1964;
(d)  42 CFR Part 493  Laboratory
			 Requirements and ORS chapter 438 (Clinical Laboratories).
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0170 - Denial or Recovery of Reimbursement Resulting from Review or Audit

Current through Register Vol. 63, No. 7, July 1, 2024
(1) OFH's staff,
			 contractor or auditor may review a claim for assurance that the specific
			 medical service was provided in accordance with the program's policies and
			 rules and the generally accepted standards of a provider's scope of practice or
			 specialty.
(2) Payment may be
			 denied or subject to recovery if review or audit determines the service does
			 not meet the program's policies, rules or the Standards of Care for Breast and
			 Cervical Cancer Screening and Diagnostic Services set forth in OAR
			 333-010-0130.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0175 - Recovery of Overpayments to Providers Resulting from Review or Audit

Current through Register Vol. 63, No. 7, July 1, 2024
(1) When the Center
			 determines that an overpayment has been made to a provider, the amount of
			 overpayment is subject to recovery:
(a) To
			 determine the overpayment amount, the Center may use a statistically valid
			 random sampling, with sufficient sample size allowing a confidence interval of
			 95 percent.
(b) After the Center
			 determines an overpayment amount by the random sampling method set forth in
			 section (1) of this rule, the provider may request a 100 percent audit of all
			 billings submitted to the Center for breast and cervical cancer screening and
			 diagnostic services provided during the period in question. If a 100 percent
			 audit is requested:
(A) Payment and
			 arrangement for a 100 percent audit is the responsibility of the provider
			 requesting the audit; and
(B) The
			 audit must be conducted by a certified public accountant that is knowledgeable
			 about the Oregon Administrative Rules covering the payments in question, and
			 must be conducted within 120 calendar days of the request to use such audit in
			 lieu of the Center's random sample.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0185 - Provider Appeals

Current through Register Vol. 63, No. 7, July 1, 2024
A provider may appeal certain decisions affecting the provider
				made by OFH. There are two levels of appeal. Level 1 is a reconsideration on a
				claim. Level 2 is a contested case hearing.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0190 - Provider Appeals (Level 1) - Claims Reconsideration

Current through Register Vol. 63, No. 7, July 1, 2024
A provider disputing OFH's claim decision may request
				reconsideration. The provider must submit the request in writing to OFH. The
				request must include the reason for the dispute, and any information pertinent
				to the outcome of the dispute. OFH will complete an additional review and
				respond back to the provider in writing. If the provider is not satisfied with
				the review, the provider may request a contested case
				hearing.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0195 - Provider Appeals (Level 2) - Contested Case Hearing Contested case hearings will be held in accordance with ORS 183

Current through Register Vol. 63, No. 7, July 1, 2024
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS
				  413.042
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0197 - Presumptive Eligibility for BCCTP

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Any licensed health care provider who can
			 diagnose breast or cervical cancer may presumptively enroll a client into BCCTP
			 and refer the client to the Oregon Health Plan if she meets the presumptive
			 eligibility criteria as described in section (2) of this rule.
(2) In order to be presumptively enrolled
			 into BCCTP a client must meet the eligibility criteria in OAR 333-010-0110  and
			 410-200-0400.
Stat. Auth.: ORS
				  413.042,
				  414.540
Stats. Implemented: ORS
				  414.534,
				  414.536
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 10 - HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION › Section 333-010-0200 - Description of the WISEWOMAN Program

Current through Register Vol. 63, No. 7, July 1, 2024
The WISEWOMAN (WW) Program is a federal program, administered
				by the Oregon Health Authority, that provides heart disease, stroke and
				diabetes screening support to develop and maintain healthy behaviors, and
				referral services in an effort to prevent cardiovascular disease to eligible
				women statewide. The WW Program provides these services through a contract
				network of qualified providers. These rules (OAR
				333-010-0200 through
				333-010-0290) apply only to providers who have an approved medical services agreement to
				provide screening and services through this program. The program is limited to
				a finite source of funds, which may restrict availability of services on an
				annual basis.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 413.042,
				  431.250