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Section 415.001 - Reinsurance program for coordinated care organizations (CCOs). - (a) "Attachment point" means the threshold dollar amount, adopted by...
Section 415.011 - Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers; rules. - (2) The authority shall adopt rules for regulating the financial...
Section 415.012 - Definitions for ORS 415.012 to 415.430. - (1) "Coordinated care organization" has the meaning given that term...
Section 415.013 - Powers and authority to enforce ORS 415.012 to 415.430 and 415.501. - (2) The authority has the powers and authority expressly conferred...
Section 415.015 - Prohibited conflicts of interest of officer or employee of Oregon Health Authority with responsibility for enforcement. - (a) Be a director, officer or employee of or be...
Section 415.019 - Right to contested case hearing. - (2) The provisions of ORS chapter 183 govern the hearing...
Section 415.055 - Confidentiality of complaints; exceptions; publication of annual statistical report of complaints against all CCOs. - (2) Data gathered pursuant to an investigation by the authority...
Section 415.056 - Confidentiality of reports regarding certain financial information. - (2) A report filed with the authority according to requirements...
Section 415.057 - Authorized use of confidential reports regarding financial information. - (2) The authority may not use reports and financial plans...
Section 415.061 - Definitions for 415.061 to 415.067. - (1) "Compliance audit" means a voluntary internal evaluation, review, assessment,...
Section 415.062 - Compliance self-evaluative audit document privileged; auditor not subject to examination in administrative or judicial proceeding. - (1) A compliance self-evaluative audit document is privileged information and...
Section 415.063 - Permissible use of compliance self-evaluative audit document by Oregon Health Authority; consideration of document in determining of civil penalty. - (2) Any compliance self-evaluative audit document submitted to the authority...
Section 415.064 - Waiver of privilege; permitted disclosures. - (2) The privilege set forth in ORS 415.062 does not...
Section 415.065 - Petition for in camera hearing on privilege of compliance self-evaluative audit document; hearing on petition; compelled disclosure. - (2) A petition filed by a coordinated care organization under...
Section 415.066 - Exceptions to privilege of compliance self-evaluative audit document. - (1) Documents, communications, data, reports or other information expressly required...
Section 415.105 - Investigations authorized. - (1) A coordinated care organization; (2) A person proposing to...
Section 415.109 - Conduct of examination; access to records; civil penalty. - (2) The authority may retain appraisers, independent actuaries, independent certified...
Section 415.111 - Report of examination; opportunity to respond. - (2) The authority shall make a copy of the report...
Section 415.115 - Annual audits; rules. - (a) The financial position of the coordinated care organization as...
Section 415.119 - Immunity from suit arising out of investigation, examination or provision or dissemination of information; attorney fees to prevailing party authorized. - (a) Any statements made or conduct performed in good faith...
Section 415.203 - Opportunity to cure impairment of required capitalization. - (a) Proceed immediately to petition for an order of rehabilitation...
Section 415.204 - Grounds for order of supervision; right to hearing to contest order. - (2) The authority may place a coordinated care organization under...
Section 415.205 - Period of supervision; cause of action for violation of order of supervision. - (2) If the authority determines that the conditions giving rise...
Section 415.251 - Jurisdiction of delinquency proceedings. - (2) The venue of delinquency proceedings and proceedings under ORS...
Section 415.252 - Exclusive remedy. - (2) A coordinated care organization shall appeal an order granting...
Section 415.261 - Petition for delinquency proceeding. - (2) The application shall be by petition, verified by the...
Section 415.263 - Cooperation with Oregon Health Authority in delinquency investigation or proceeding. - (a) Replying promptly in writing to any inquiry from the...
Section 415.265 - Injunction prohibiting waste or disposition of property upon petition for delinquency proceeding. - (2) The court may at any time during a delinquency...
Section 415.280 - Petition for order for rehabilitation or liquidation of CCO. - (a) Directing the authority to rehabilitate a coordinated care organization...
Section 415.281 - Court order for rehabilitation or liquidation proceeding against CCO. - (2) On motion of the authority or the coordinated care...
Section 415.300 - Rehabilitation proceeding. - (2) If at any time the authority deems that further...
Section 415.330 - Grounds for order to liquidate. - (1) Has ceased transacting business for a period of one...
Section 415.333 - Powers of Oregon Health Authority in liquidation proceeding. - (1) Subject to a court’s direction, immediately conduct the business...
Section 415.335 - Order to liquidate. - (a) Take possession of the property of the coordinated care...
Section 415.340 - Oregon Health Authority to be appointed receiver in delinquency proceeding; powers and duties. - (2) Any deed or other instrument executed in a delinquency...
Section 415.341 - Immunity from civil liability for receivers. - (a) All receivers responsible for the conduct of a delinquency...
Section 415.400 - Filing proof of claim against CCO declared by court to be insolvent. - (2) A claimant filing a proof of claim after the...
Section 415.401 - Requirements for proof of claim. - (a) Set forth in reasonable detail: (A) The amount of...
Section 415.402 - Preference of claims. - (1) The expenses of administering the delinquency proceedings; (2) Claims...
Section 415.404 - Contingent claims. - (2) Nothing in subsection (1) of this section prevents or...
Section 415.405 - Priority of special deposit claims. - (1) The payment of claims of general creditors; and (2)...
Section 415.422 - Voidable transfers or liens. - (a) Made or created within four months prior to the...
Section 415.430 - Liability of member of CCO to pay provider for cost of care. - (2) Each contract between a coordinated care organization and a...
Section 415.500 - Definitions. - (1) "Corporate affiliation" has the meaning prescribed by the Oregon...
Section 415.501 - Procedures for review of material change transactions; rules. - (2) In accordance with subsection (1) of this section, the...
Section 415.505 - Conflicts of interest prohibited. - (a) Be a director, officer or employee of or be...
Section 415.510 - Quadrennial study of impact of health care consolidation. - (1) The impact on costs to consumers for health care...
Section 415.512 - Fees; rules. - (2) Moneys received by the authority under this section shall...
Section 415.900 - Civil penalties. - (2) Civil penalties shall be imposed and enforced in accordance...