OAR 333-010-0105
Definitions


(1)

“Agency number” means the administrative number assigned to the service provider by the Center for Prevention and Health Promotion (Center) for identification as a ScreenWise Breast and Cervical Cancer services (ScreenWise BCC) provider.

(2)

“Ancillary provider” means a provider that performs services beyond the scope of an enrolling provider. Ancillary providers may include but is not limited to laboratories, imaging centers, surgeons and surgical facilities, and hospitals.

(3)

“Approved medical services agreement” means the completed ScreenWise BCC agreement, submitted to and approved by the Center for Prevention and Health Promotion.

(4)

“Authority” means the Oregon Health Authority.

(5)

“BCCTP” means the Breast and Cervical Cancer Treatment Program. ORS 414.534 (Treatment for breast or cervical cancer), 414.536 (Presumptive eligibility for medical assistance for treatment of breast or cervical cancer).

(6)

“Care coordination or case management” means that a client is provided with services, results, follow-up recommendations, and active tracking of progress towards follow-up recommendations.

(7)

“Center” means the Center for Prevention and Health Promotion, the office within the Oregon Health Authority that administers the ScreenWise BCC.

(8)

“CLIA” means the federal Clinical Laboratory Improvement Amendments of 1988, establishes quality standards for all laboratory testing to ensure the accuracy, reliability and timeliness of patient test results, and allows for certification of clinical laboratories operating in accordance with these federal amendments.

(9)

“Client” means a person of any age or gender who is enrolled in and receives screening or diagnostic services from the ScreenWise BCC.

(10)

“Enrolling provider” means a provider that enrolls a client into the ScreenWise BCC, provides care coordination for the client and timely data submission to ScreenWise BCC.

(11)

“FPL” means the federal poverty level guidelines established each year by the Department of Health and Human Services, used to determine eligibility for ScreenWise BCC and other federally funded programs.

(12)

“HIPAA” means the Health Insurance Portability and Accountability Act.

(13)

“ScreenWise BCC” means the ScreenWise program component that provides statewide breast and cervical cancer screening and diagnostic services to eligible clients, that is administered by the Center for Prevention and Health Promotion within the Oregon Health Authority.

(14)

“ScreenWise BCC Provider Network” means the combination of all contracted ScreenWise providers, including enrolling and ancillary providers.

(15)

“Service provider” or “provider” means a licensed health care provider operating within a scope of practice, who is authorized by the Center to bill for breast and cervical cancer screening and diagnostic services for eligible clients.

(16)

“Site number” means the administrative number assigned to the provider by the Center for identification of the geographic location of each ScreenWise BCC provider.

(17)

“Underinsured” means that health insurance does not fully cover breast and cervical cancer screening services or that out-of-pocket cost sharing for diagnostic services would pose a financial hardship.
333–010–0000
Cancer Reporting Regulations: Definitions
333–010–0020
Cancer Reporting Regulations: Reporting Requirements for Health Care Facilities
333–010–0030
Cancer Reporting Regulations: Reporting Requirements for Practitioners
333–010–0032
Cancer Reporting Regulations: Reporting Requirements for Clinical Laboratories
333–010–0035
Cancer Reporting Regulations: Patient Notification Requirement
333–010–0040
Cancer Reporting Regulations: Quality Standards
333–010–0050
Cancer Reporting Regulations: Confidentiality and Access to Data
333–010–0055
Cancer Reporting Regulations: Research Studies
333–010–0060
Cancer Reporting Regulations: Special Studies
333–010–0070
Cancer Reporting Regulations: Advisory Committee
333–010–0080
Cancer Reporting Regulations: Training and Consultation
333–010–0090
Cancer Reporting Regulations: Fees
333–010–0100
ScreenWise Breast and Cervical Cancer Program: Description of the ScreenWise Breast and Cervical Cancer Program
333–010–0105
Definitions
333–010–0110
Client Eligibility
333–010–0115
Client Enrollment
333–010–0120
Covered Services
333–010–0125
Excluded Services
333–010–0130
Standards of Care for Breast and Cervical Cancer Screening and Diagnostic Services
333–010–0135
Provider Enrollment
333–010–0140
Billing
333–010–0145
Claims and Data Submission
333–010–0150
Timely Submission of Claims and Data
333–010–0155
Payment
333–010–0160
Requirements for Financial, Clinical and Other Records
333–010–0165
Compliance with Federal and State Statutes
333–010–0170
Denial or Recovery of Reimbursement Resulting from Review or Audit
333–010–0175
Recovery of Overpayments to Providers Resulting from Review or Audit
333–010–0180
Provider Sanctions
333–010–0185
Provider Appeals
333–010–0190
Provider Appeals (Level 1) — Claims Reconsideration
333–010–0195
Provider Appeals (Level 2) — Contested Case Hearing
333–010–0197
Presumptive Eligibility for BCCTP
333–010–0200
ScreenWise WISEWOMAN Program: Description of the WISEWOMAN Program
333–010–0205
Definitions
333–010–0210
Client Eligibility
333–010–0215
Client Enrollment
333–010–0220
Provider Enrollment
333–010–0225
Standards of Care for WISEWOMAN Program Screening and Services
333–010–0230
Submission of Information by Ancillary Providers
333–010–0235
Covered Services
333–010–0240
Excluded Services
333–010–0245
Claims and Billing
333–010–0250
Payment
333–010–0255
Denial or Recovery of Reimbursement Resulting from Review or Audit
333–010–0260
Recovery of Overpayments to Providers Resulting from Review or Audit
333–010–0265
Client Data Submission
333–010–0270
Requirements for Financial, Clinical and Other Records
333–010–0275
Compliance with Federal and State Statutes
333–010–0280
Provider Sanctions
333–010–0285
Provider Appeals (Level 1) — Claims Reconsideration
333–010–0290
Provider Appeals (Level 2) — Contested Case Hearing
333–010–0300
Tobacco Prevention and Education Program: Definitions
333–010–0310
Tobacco Prevention and Education Program: Purpose and Intent
333–010–0320
Tobacco Prevention and Education Program: Framework for Grant Awards
333–010–0330
Tobacco Prevention and Education Program: Local Coalitions and Community-Based Programs
333–010–0350
Tobacco Prevention and Education Program: Statewide Public Awareness and Education Programs
333–010–0360
Tobacco Prevention and Education Program: Statewide and Regional Projects Programs
333–010–0370
Tobacco Prevention and Education Program: Reporting
333–010–0600
Childhood Diabetes Database: Definitions
333–010–0610
Childhood Diabetes Database: General Authority and Purpose
333–010–0620
Childhood Diabetes Database: Reporting Requirements for Schools
333–010–0630
Childhood Diabetes Database: Reporting Requirements for Practitioners
333–010–0640
Childhood Diabetes Database: Confidentiality and Access to Data
333–010–0650
Childhood Diabetes Database: Research Studies
333–010–0660
Childhood Diabetes Database: Advisory Committee
333–010–0700
Dental Pilot Projects: Purpose
333–010–0710
Dental Pilot Projects: Definitions
333–010–0720
Dental Pilot Projects: Application Procedure
333–010–0730
Dental Pilot Projects: Application Review Process
333–010–0740
Dental Pilot Projects: Project Application Provisional Approval or Denial
333–010–0750
Dental Pilot Projects: Provisional Approval
333–010–0760
Dental Pilot Projects: Minimum Standards
333–010–0770
Dental Pilot Projects: Informed Consent
333–010–0780
Dental Pilot Projects: Pilot Project Evaluation and Monitoring by Sponsor
333–010–0790
Dental Pilot Projects: Authority Responsibilities
333–010–0800
Dental Pilot Projects: Project Modifications
333–010–0810
Dental Pilot Projects: Discontinuation or Completion of Project
333–010–0820
Dental Pilot Projects: Suspension, Denial or Termination of Project
Last Updated

Jun. 8, 2021

Rule 333-010-0105’s source at or​.us