(1) "Compliance audit" means a voluntary internal evaluation, review, assessment, audit or investigation that is undertaken to identify or prevent noncompliance with, or promote compliance with, laws, regulations, orders or professional standards, and that is conducted by or on behalf of a coordinated care organization.
(2)(a) "Compliance self-evaluative audit document" means a document prepared as a result of or in connection with a compliance audit.
(b) "Compliance self-evaluative audit document" includes, but is not limited to:
(A) A written response to the findings of a compliance audit.
(B) Field notes and records of observations, findings, opinions, suggestions, conclusions, drafts, memoranda, drawings, photographs, exhibits, computer-generated or electronically recorded information, phone records, maps, charts, graphs and surveys, provided this supporting information is collected or developed solely for the purpose of a compliance audit.
(C) A compliance audit report prepared by an auditor, who may be an employee of the coordinated care organization or an independent contractor, which may include the scope of the audit, the information gained in the audit and conclusions and recommendations, with exhibits and appendices.
(D) Memoranda and documents analyzing portions or all of the compliance audit report and discussing potential implementation issues.
(E) An implementation plan that addresses correcting past noncompliance, improving current compliance and preventing future noncompliance.
(F) Analytic data generated in the course of conducting the compliance audit, not including any analytic data that exists independently of the audit or existed before the audit was conducted. [2019 c.478 ยง16]
Structure 2021 Oregon Revised Statutes
Volume : 11 - Juvenile Code, Human Services
Chapter 415 - Regulation of Health Care Entities
Section 415.001 - Reinsurance program for coordinated care organizations (CCOs).
Section 415.012 - Definitions for ORS 415.012 to 415.430.
Section 415.013 - Powers and authority to enforce ORS 415.012 to 415.430 and 415.501.
Section 415.019 - Right to contested case hearing.
Section 415.056 - Confidentiality of reports regarding certain financial information.
Section 415.057 - Authorized use of confidential reports regarding financial information.
Section 415.061 - Definitions for 415.061 to 415.067.
Section 415.064 - Waiver of privilege; permitted disclosures.
Section 415.066 - Exceptions to privilege of compliance self-evaluative audit document.
Section 415.105 - Investigations authorized.
Section 415.109 - Conduct of examination; access to records; civil penalty.
Section 415.111 - Report of examination; opportunity to respond.
Section 415.115 - Annual audits; rules.
Section 415.203 - Opportunity to cure impairment of required capitalization.
Section 415.204 - Grounds for order of supervision; right to hearing to contest order.
Section 415.205 - Period of supervision; cause of action for violation of order of supervision.
Section 415.251 - Jurisdiction of delinquency proceedings.
Section 415.252 - Exclusive remedy.
Section 415.261 - Petition for delinquency proceeding.
Section 415.280 - Petition for order for rehabilitation or liquidation of CCO.
Section 415.281 - Court order for rehabilitation or liquidation proceeding against CCO.
Section 415.300 - Rehabilitation proceeding.
Section 415.330 - Grounds for order to liquidate.
Section 415.333 - Powers of Oregon Health Authority in liquidation proceeding.
Section 415.335 - Order to liquidate.
Section 415.341 - Immunity from civil liability for receivers.
Section 415.400 - Filing proof of claim against CCO declared by court to be insolvent.
Section 415.401 - Requirements for proof of claim.
Section 415.402 - Preference of claims.
Section 415.404 - Contingent claims.
Section 415.405 - Priority of special deposit claims.
Section 415.422 - Voidable transfers or liens.
Section 415.430 - Liability of member of CCO to pay provider for cost of care.
Section 415.500 - Definitions.
Section 415.501 - Procedures for review of material change transactions; rules.
Section 415.505 - Conflicts of interest prohibited.
Section 415.510 - Quadrennial study of impact of health care consolidation.