ORS 413.164
Collection and reporting of data by health care providers and insurers

  • rules

(1)

As used in this section and ORS 413.163 (System for collecting data on race, ethnicity, language, disability, sexual orientation and gender identity) and 413.167 (Reports to Legislative Assembly):

(a)

“Board” means the:

(A)

State Board of Examiners for Speech-Language Pathology and Audiology;

(B)

State Board of Chiropractic Examiners;

(C)

State Board of Licensed Social Workers;

(D)

Oregon Board of Licensed Professional Counselors and Therapists;

(E)

Oregon Board of Dentistry;

(F)

State Board of Massage Therapists;

(G)

Oregon Board of Naturopathic Medicine;

(H)

Oregon State Board of Nursing;

(I)

Oregon Board of Optometry;

(J)

State Board of Pharmacy;

(K)

Oregon Medical Board;

(L)

Occupational Therapy Licensing Board;

(M)

Oregon Board of Physical Therapy;

(N)

Oregon Board of Psychology;

(O)

Board of Medical Imaging;

(P)

Long Term Care Administrators Board;

(Q)

State Board of Direct Entry Midwifery;

(R)

State Board of Denture Technology;

(S)

Respiratory Therapist and Polysomnographic Technologist Licensing Board;

(T)

Board of Licensed Dietitians; and

(U)

Oregon Health Authority, to the extent that the authority:
(i)
Licenses emergency medical services providers under ORS 682.216 (Issuance of licenses); and
(ii)
Regulates traditional health workers under ORS 414.665 (Traditional health workers utilized by coordinated care organizations).

(b)

“Coordinated care organization” has the meaning given that term in ORS 414.025 (Definitions for ORS chapters 411, 413 and 414).

(c)

“Health care provider” means an individual licensed, certified, registered or otherwise authorized to practice by a board.

(d)

“Health insurer” has the meaning given that term in ORS 746.600 (Definitions for ORS 746.600 to 746.690).

(2)

At least once each calendar year and in accordance with timelines established by the authority by rule, a coordinated care organization, a health care provider or health care provider’s designee, or a health insurer shall collect data on race, ethnicity, preferred spoken and written languages, disability status, sexual orientation and gender identity from the coordinated care organization’s, health care provider’s or health insurer’s patients, clients and members, in accordance with standards adopted by the authority pursuant to ORS 413.161 (Collection of data on race, ethnicity, language, disability status, sexual orientation and gender identity). A coordinated care organization, health care provider or health insurer shall submit the data to the authority in the manner prescribed by the authority by rule.

(3)

Intentionally left blank —Ed.

(a)

The authority shall adopt rules, including but not limited to rules:

(A)

Establishing standards for collecting, securely transmitting and reporting the data described in subsection (2) of this section;

(B)

Establishing the timelines for collection and submission of data described in subsection (2) of this section;

(C)

Permitting coordinated care organizations, health care providers and health insurers to report to the authority that a patient, client or member refused to answer questions regarding race, ethnicity, preferred spoken and written languages, disability status, sexual orientation and gender identity;

(D)

Establishing criteria for extensions of timelines established under this subsection and a process for reviewing requests for extensions; and

(E)

Establishing criteria for exempting certain health care providers or classes of health care providers from the requirements of subsection (2) of this section and a process for reviewing requests for exemptions.

(b)

In adopting rules under subsection (2) of this section, the authority shall:

(A)

Consult with the advisory committee established under ORS 413.161 (Collection of data on race, ethnicity, language, disability status, sexual orientation and gender identity);

(B)

Allow coordinated care organizations, health care providers and health insurers to collect the data described in subsection (2) of this section on electronic or paper forms; and

(C)

Require coordinated care organizations, health care providers and health insurers to inform patients, clients and members:
(i)
That data collected under subsection (2) of this section is reported to the authority;
(ii)
How the authority, coordinated care organization, health care provider and health insurer use the data;
(iii)
Of the purposes for which the data may not be used; and
(iv)
That the patient, client or member is not required to answer questions regarding race, ethnicity, preferred spoken and written languages, disability status, sexual orientation and gender identity.

(4)

Data collected under this section is confidential and not subject to disclosure under ORS 192.311 (Definitions for ORS 192.311 to 192.478) to 192.478 (Exemption for Judicial Department). The authority may release the data collected under this section only if the data to be released is anonymized and aggregated so that the data released does not reasonably allow an individual whose information is included in the data to be identified.

(5)

A coordinated care organization or health insurer transacting insurance in this state may not consider any data collected under subsection (2) of this section:

(a)

In determining whether to deny, limit, cancel, rescind or refuse to renew an insurance policy;

(b)

To establish premium rates for an insurance policy; or

(c)

To establish the terms and conditions of an insurance policy.

(6)

The authority may provide incentives to coordinated care organizations, health care providers and health insurers to assist in deferring the costs of making changes to electronic health records systems or similar systems to facilitate the collection of data described in subsection (2) of this section.

(7)

Intentionally left blank —Ed.

(a)

The authority shall monitor coordinated care organizations, health care providers and health insurers for compliance with the standards established under subsection (1) of this section.

(b)

The authority may impose on a coordinated care organization, health care provider or health insurer a civil penalty for a violation of the requirements of this section or rules adopted under this section:

(A)

Not to exceed $200 for the first violation;

(B)

Not to exceed $400 for the second violation; and

(C)

Not to exceed $500 for the third and subsequent violations.

(c)

Prior to imposing a penalty under paragraph (b) of this subsection, the authority shall provide notice to the coordinated care organization, health care provider or health insurer of the alleged violation and provide the coordinated care organization, health care provider or health insurer a reasonable time in which to correct the violation. [2021 c.549 §1]
Note: See second note under 413.161 (Collection of data on race, ethnicity, language, disability status, sexual orientation and gender identity).

Source: Section 413.164 — Collection and reporting of data by health care providers and insurers; rules, https://www.­oregonlegislature.­gov/bills_laws/ors/ors413.­html.

413.006
Establishment of Oregon Health Policy Board
413.007
Composition of board
413.008
Chairperson
413.011
Duties of board
413.014
Rules
413.016
Authority of board to establish advisory and technical committees
413.017
Public Health Benefit Purchasers Committee, Health Care Workforce Committee, Health Plan Quality Metrics Committee and Behavioral Health Committee
413.032
Establishment of Oregon Health Authority
413.033
Oregon Health Authority director
413.034
Oregon Health Authority officers and employees
413.036
Use of abuse and neglect reports for screening subject individuals
413.037
Administering oaths
413.038
Service of notice by regular mail
413.041
Persons authorized to represent parties in contested cases
413.042
Rules
413.046
Right to courteous, fair and dignified treatment
413.071
Authorization to request federal waivers
413.072
Public process required if waiver of federal requirement involves policy change
413.083
Dental director
413.084
State School Nursing Consultant
413.085
Cross-delegation by directors of Department of Human Services, Department of Consumer and Business Services and Oregon Health Authority
413.101
Oregon Health Authority Fund
413.105
Deposit of reimbursements received for medical assistance expenditures
413.109
Acceptance and expenditures of funds received from private sources
413.121
Oregon Health Authority Special Checking Account
413.125
Revolving fund
413.129
Aggregation of warrants and payments
413.135
Combining and eliminating accounts
413.151
Setoff of liquidated and delinquent debts
413.161
Collection of data on race, ethnicity, language, disability status, sexual orientation and gender identity
413.162
Reports to Legislative Assembly on collection of data under ORS 413.161
413.163
System for collecting data on race, ethnicity, language, disability, sexual orientation and gender identity
413.164
Collection and reporting of data by health care providers and insurers
413.166
Grants for data collection
413.167
Reports to Legislative Assembly
413.171
Sharing of data with Department of Human Services
413.175
Prohibition on disclosure of information
413.181
Disclosure of insurer information by Department of Consumer and Business Services for purpose of administering Oregon Integrated and Coordinated Care Delivery System
413.195
Disclosure of information about cremated or reduced remains
413.196
Confidentiality and inadmissibility of information obtained in connection with epidemiologic morbidity and mortality studies
413.201
Targeted outreach for Cover All People program
413.223
School-based health centers
413.225
Grants to safety net providers
413.227
Oregon Health Authority reimbursement of coordinated care organization’s costs to provide services related to improving student access to school-based oral health services
413.231
Recruitment of primary care providers
413.234
Supplemental payments to emergency services providers
413.235
Emergency services intergovernmental transfer program
413.236
Coordinated care organization reimbursement of emergency medical services providers
413.246
Information provided to retired physicians and health care providers
413.248
Physician Visa Waiver Program
413.250
Statewide Health Improvement Program
413.255
Cooperative research and demonstration projects for health and health care purposes
413.256
Regional health equity coalitions
413.257
Experimental, prototype health care of tomorrow
413.259
Patient centered primary care home program and behavioral health home program
413.260
Patient centered primary care and behavioral health home delivery models
413.270
Advisory council
413.271
Palliative care information and resources
413.273
Palliative care for patients and residents of hospitals, long term care facilities and residential care facilities
413.300
Definitions for ORS 413.300 to 413.308, 413.310 and ORS chapter 414
413.301
Health Information Technology Oversight Council
413.303
Council chairperson
413.308
Duties of council
413.310
Oregon Health Information Technology program
413.430
Functions of Director of Oregon Health Authority regarding health professionals
413.435
Administrative requirements for students in clinical training
413.450
Continuing education in cultural competency
413.500
Women, Infants and Children Program
413.520
Gambling addiction programs in Oregon Health Authority
413.522
Problem Gambling Treatment Fund
413.550
Definitions for ORS 413.550 to 413.559
413.552
Legislative findings and policy on health care interpreters
413.554
Oregon Council on Health Care Interpreters
413.556
Testing, qualification and certification standards for health care interpreters
413.558
Procedures for testing, qualifications and certification of health care interpreters
413.559
Requirement for provider to work with health care interpreter from registry
413.560
Moneys received credited to account in Oregon Health Authority Fund
413.561
Agencies or boards with enforcement authority
413.562
State of Oregon as employer of health care interpreters for purposes of collective bargaining only
413.563
Requirement for interpretation service company to use health care interpreters from registry
413.570
Pain Management Commission
413.572
Additional duties of commission
413.574
Membership of commission
413.576
Selection of chairperson and vice chairperson
413.580
Pain Management Fund
413.582
Acceptance of contributions
413.590
Pain management education required of certain licensed health care professionals
413.599
Rules
413.600
Traditional Health Workers Commission
413.610
Purpose of Compact of Free Association Premium Assistance Program
413.611
Definitions
413.612
Eligibility for program
413.613
COFA Premium Assistance Program Fund
413.800
Emergency planning
Green check means up to date. Up to date