OAR 836-200-0305
Retainer Medical Practice Application for Certification
(1)
The Director of the Department of Consumer and Business Services may certify a retainer medical practice for a period of one year or more, if the applicant:(a)
Acts in accordance with the attestations required by paragraph (c) of this section;(b)
Complies with and meets the requirements of OAR 836-200-0300 (Statement of Purpose; Authority) to 836-200-0315 (Disclosures; Form and Contents) and sections 2 and 3, chapter 499, Oregon Laws 2011 (Enrolled Senate Bill 86); and(c)
Completes and submits to the satisfaction of the director a retainer medical practice application as set forth on the website for the Insurance Division of the Department of Consumer and Business Services at www.insurance.oregon.gov. As required on the form, the applicant shall:(A)
Attest to the following:(i)
Under the retainer medical agreement providers providing services are licensed or certified under ORS Chapters 677, 678, 684, or 685 and the services provided will be limited to primary care services allowed within the scope of such licenses or certifications.(ii)
The applicant is not and has never been authorized in this or any other state to transact insurance or act as an insurer, managed care organization, health care services contractor, or similar entity;(iii)
The applicant is not controlled by any person described in subparagraph (ii) of this paragraph;(iv)
The applicant will structure the retainer medical practice to ensure that all services promised under the retainer medical agreement are within the capacity of the practice to provide in a timely manner;(v)
The applicant is financially responsible and has the necessary business experience or expertise to operate the practice;(vi)
The applicant will not discriminate based on race, religion, gender, sexual identity, sexual preference, or health status;(vii)
The applicant is authorized to conduct business in the State of Oregon and has complied with all registration requirements of this State; and(viii)
The information provided in the application and all supplemental and additional information is true and complete, and the applicant will submit to the jurisdiction of the courts of the State of Oregon.(B)
Establish to the satisfaction of the director that the applicant is financially responsible. To establish that an applicant is financially responsible, the applicant must provide all of the following:(i)
A statement of whether the applicant has filed for bankruptcy during the 25- year period prior to the application or renewal.(ii)
The applicant’s business plan, including a discussion of how the applicant intends to monitor the practice to ensure the services promised under the retainer medical agreement are provided in a timely manner. The plan must include a clear description of how the retainer medical practice will ensure repayment of retainer medical fees paid in advance if the retainer medical practice is unable to provide the services promised under the retainer medical agreement.(iii)
A copy of any marketing materials and the retainer medical agreement that will be used for the 12-month certification period and each subsequent renewal. The agreement must include provisions that obligate the retainer medical practice to reimburse retainer medical patients for retainer medical fees paid in advance in the event the retainer medical practice is unable to provide services promised under the retainer medical agreement.(C)
Establish that the applicant has the necessary experience and expertise to operate a retainer medical practice by providing all of the following:(i)
The name of any other jurisdiction in which the applicant currently holds a license, registration or certification to transact business as a retainer medical practice or similar entity, or has held such a license or certification within ten years prior to the date of the application.(ii)
A statement of whether any license or registration of the applicant or any person with control of the applicant has ever been denied, suspended, revoked or not renewed in this or any other state and whether the applicant or any person with control of the applicant has otherwise ever been the subject of an enforcement action taken by a licensing or registration agency. For any action taken, the applicant shall provide the name and address of the licensing or registration agency, the date of the action taken against the license or registration and a description of the reason for the action taken against the license or registration.(iii)
A biographical affidavit in the form and manner prescribed by the director, completed by each member of the board of directors, executive committee, or other governing board or committee of the applicant; and(iv)
A statement describing the background or training of the applicant that provides the necessary business experience or expertise to operate a retainer medical practice. The statement shall include the number of years the applicant has been in practice. The statement may also include a description of any similar business the applicant has operated, how many years the applicant operated the similar business and any pertinent training or experience the applicant has completed that has allowed the applicant to develop the necessary experience or expertise to operate a practice. The experience need not be specific to a retainer medical practice.(D)
Provide the names and Oregon license numbers of all providers providing services through the medical retainer practice.(E)
Provide the physical and mailing address, telephone number, facsimile number, email address and website address for each location providing retainer medical services.(F)
Provide the name and address for service of process for the retainer medical practice.(G)
Provide the name, mailing address, telephone number, signature and email address of the person completing the application on behalf of the applicant.(H)
Provide all names, including assumed business names, under which the retainer medical practice will operate, market or otherwise do business.(2)
Intentionally left blank —Ed.(a)
A retainer medical practice certification issued on or before February 1 of any given year is valid through January 31 of the following year.(b)
A retainer medical practice certification issued after February 1 of any given year is valid through January 31 of the second year following the year of certification.
Source:
Rule 836-200-0305 — Retainer Medical Practice Application for Certification, https://secure.sos.state.or.us/oard/view.action?ruleNumber=836-200-0305.