2021 Oregon Revised Statutes
Chapter 414 - Medical Assistance
Section 414.871 - Applicability of hospital assessment.

2021 Oregon Revised Statutes

Volume : 11 - Juvenile Code, Human Services

Chapter 414 - Medical Assistance

Section 414.018 - Legislative intent; findings.

Section 414.025 - Definitions for ORS chapters 411, 413 and 414.

Section 414.033 - Expenditures for medical assistance authorized.

Section 414.034 - Acceptance of federal billing, reimbursement and reporting forms.

Section 414.041 - Simplified application process; outreach and enrollment.

Section 414.044 - Notice to Department of Veterans’ Affairs of information regarding applications for health care coverage by uniformed service members and veterans; rules.

Section 414.065 - Determination of health care and services covered; quality measures; reimbursement; cost sharing; payments by Oregon Health Authority as payment in full; rules.

Section 414.066 - Billing patient for services covered by medical assistance prohibited.

Section 414.067 - Coordinated care organization assumption of costs; reports to Legislative Assembly.

Section 414.071 - Timely payment for dental services.

Section 414.072 - Prior authorization data and reports.

Section 414.075 - Payment of deductibles imposed under federal law.

Section 414.109 - Oregon Health Plan Fund.

Section 414.115 - Medical assistance by insurance or service contracts; rules.

Section 414.117 - Premium assistance for health insurance coverage.

Section 414.125 - Rates on insurance or service contracts; requirements for insurer or contractor.

Section 414.135 - Contracts relating to direct providers of care and services.

Section 414.145 - Implementation of ORS 414.115, 414.125 or 414.135.

Section 414.150 - Purpose of ORS 414.150 to 414.153.

Section 414.152 - Duty of state agencies to work with local health departments.

Section 414.153 - Services provided by local health departments.

Section 414.211 - Medicaid Advisory Committee.

Section 414.221 - Duties of committee.

Section 414.227 - Application of public meetings law to advisory committees.

Section 414.231 - Eligibility for Cover All People program; 12-month continuous enrollment; verification of eligibility.

Section 414.312 - Oregon Prescription Drug Program.

Section 414.314 - Application and participation in Oregon Prescription Drug Program; prescription drug charges; fees.

Section 414.318 - Prescription Drug Purchasing Fund.

Section 414.320 - Rules.

Section 414.325 - Prescription drugs; use of legend or generic drugs; prior authorization; rules.

Section 414.326 - Supplemental rebates from pharmaceutical manufacturers.

Section 414.327 - Electronically transmitted prescriptions; rules.

Section 414.328 - Synchronization of prescription drug refills.

Section 414.329 - Prescription drug benefits for certain persons who are eligible for Medicare Part D prescription drug coverage; rules.

Section 414.330 - Legislative findings on prescription drugs.

Section 414.332 - Policy for Practitioner-Managed Prescription Drug Plan.

Section 414.334 - Practitioner-Managed Prescription Drug Plan for medical assistance program.

Section 414.337 - Limitation on rules regarding Practitioner-Managed Prescription Drug Plan.

Section 414.351 - Definitions for ORS 414.351 to 414.414.

Section 414.353 - Committee established; membership.

Section 414.354 - Meetings; advisory committees; public notice and testimony.

Section 414.356 - Executive session.

Section 414.359 - Mental Health Clinical Advisory Group.

Section 414.361 - Committee to advise and make recommendations on drug utilization review standards and interventions; preferred drug list.

Section 414.364 - Intervention approaches.

Section 414.369 - Prospective drug use review program.

Section 414.371 - Retrospective drug use review program.

Section 414.372 - Pharmacy lock-in program; rules.

Section 414.381 - Annual reports; educational materials; procedures to protect confidential information.

Section 414.382 - Requirements for annual report.

Section 414.414 - Use and disclosure of confidential information.

Section 414.426 - Payment of cost of medical care for institutionalized persons.

Section 414.428 - Coverage for American Indian and Alaska Native beneficiaries.

Section 414.430 - Access to dental care for pregnant women; rules.

Section 414.432 - Reproductive health services for noncitizens.

Section 414.500 - Findings regarding medical assistance for persons with hemophilia.

Section 414.510 - Definitions.

Section 414.520 - Hemophilia services.

Section 414.530 - When payments not made for hemophilia services.

Section 414.532 - Definitions for ORS 414.534 to 414.538.

Section 414.534 - Treatment for breast or cervical cancer; eligibility criteria for medical assistance; rules.

Section 414.536 - Presumptive eligibility for medical assistance for treatment of breast or cervical cancer.

Section 414.538 - Prohibition on coverage limitations; priority to low-income women.

Section 414.540 - Rules.

Section 414.550 - Definitions for ORS 414.550 to 414.565.

Section 414.555 - Findings regarding medical assistance for persons with cystic fibrosis.

Section 414.560 - Cystic fibrosis services.

Section 414.565 - When payments not made for cystic fibrosis services.

Section 414.570 - System established.

Section 414.572 - Coordinated care organizations; rules.

Section 414.575 - Community advisory councils.

Section 414.577 - Community health assessment and adoption of community health improvement plan; rules.

Section 414.578 - Community health improvement plan.

Section 414.581 - Tribal Advisory Council established; membership; terms.

Section 414.584 - Meetings of coordinated care organization governing body to be open to public; recording and taking of minutes required.

Section 414.590 - Coordinated care organization contracts; terms and amendments; 60 days’ advance notice; refusal to renew.

Section 414.591 - Coordinated care organization contracts; financial reporting; rules.

Section 414.592 - Requirements for contracts between authority and providers; alignment with behavioral quality health metrics and incentives.

Section 414.593 - Reporting and public disclosure of expenditures by coordinated care organizations.

Section 414.595 - External quality reviews of coordinated care organizations; limits on documentation and reporting requirements.

Section 414.598 - Alternative payment methodologies.

Section 414.605 - Consumer and provider protections.

Section 414.607 - Use and disclosure of member information; access by member to personal health information.

Section 414.609 - Network adequacy; member transfers.

Section 414.611 - Transfer of 500 or more members of coordinated care organization.

Section 414.613 - Discrimination based on scope of practice prohibited; appeals; rules.

Section 414.619 - Coordination between Oregon Health Authority and Department of Human Services.

Section 414.628 - Innovator agents.

Section 414.631 - Mandatory enrollment in coordinated care organization; exemptions.

Section 414.632 - Services to individuals who are dually eligible for Medicare and Medicaid.

Section 414.638 - Metrics and scoring subcommittee; identification of outcome and quality measures and benchmarks.

Section 414.654 - Persons served by prepaid managed care health services organizations; funding of health information technology.

Section 414.655 - Utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations.

Section 414.665 - Traditional health workers utilized by coordinated care organizations; rules.

Section 414.669 - Payment for doula services.

Section 414.686 - Health assessments for foster children.

Section 414.688 - Commission established; membership.

Section 414.689 - Members; meetings.

Section 414.690 - Prioritized list of health services.

Section 414.694 - Commission review of covered reproductive health services.

Section 414.695 - Medical technology assessment.

Section 414.698 - Comparative effectiveness of medical technologies.

Section 414.701 - Commission may not rely solely on comparative effectiveness research.

Section 414.706 - Persons eligible for medical assistance; rules.

Section 414.710 - Services not subject to prioritized list.

Section 414.712 - Health services for certain eligible persons.

Section 414.717 - Palliative care program; rules.

Section 414.719 - Housing navigation services and social determinants of health; rules.

Section 414.723 - Telemedicine services; rules.

Section 414.726 - Requirement to use certified or qualified health care interpreters; reimbursement; rules.

Section 414.735 - Reduction in scope of health services in event of insufficient resources; approval of Legislative Assembly or Emergency Board; notice to providers.

Section 414.743 - Payment to noncontracting hospital by coordinated care organization; rules.

Section 414.755 - Payment for hospital services.

Section 414.756 - Payments to Oregon Health and Science University.

Section 414.760 - Payment for patient centered primary care home and behavioral health home services.

Section 414.762 - Payment for child abuse assessment.

Section 414.764 - Payment for services provided by pharmacy or pharmacist.

Section 414.766 - Behavioral health treatment; rules.

Section 414.767 - Survey of medical assistance recipients regarding experience with behavioral health care and services.

Section 414.770 - Participants in clinical trials.

Section 414.772 - Limits on use of step therapy.

Section 414.780 - Coordinated care organization reporting of data to assess compliance with mental health parity requirements; annual assessment.

Section 414.781 - Fee-for-service reimbursement of co-occurring mental health and substance use disorder treatment services.

Section 414.782 - Reimbursement to ensure access to addiction treatment statewide.

Section 414.805 - Liability of individual for medical services received while in custody of law enforcement officer.

Section 414.807 - Oregon Health Authority to pay for medical services related to law enforcement activity; certification of injury.

Section 414.815 - Law Enforcement Medical Liability Account; limited liability; rules; report.

Section 414.853 - Definitions.

Section 414.855 - Hospital assessment; rates; rules.

Section 414.857 - Reduction in rate required by federal law.

Section 414.863 - Refund of hospital assessment; right to contested case hearing.

Section 414.865 - Audits.

Section 414.867 - Deposit of assessments collected to Hospital Quality Assurance Fund.

Section 414.869 - Establishment of Hospital Quality Assurance Fund.

Section 414.871 - Applicability of hospital assessment.

Section 414.880 - Managed care organization assessment; rate.

Section 414.882 - Refund of managed care organization assessment; right to contested case hearing.

Section 414.884 - Applicability of managed care organization assessment.

Section 414.900 - Hospital assessment; penalties.

Section 414.902 - Managed care organization assessment; penalties.