ORS 442.325
Certificate of need for health care facility of health maintenance organization

  • exempt activities
  • policy relating to health maintenance organizations

(1)

A certificate of need shall be required for the development or establishment of a health care facility of any new health maintenance organization.

(2)

Any activity of a health maintenance organization which does not involve the direct delivery of health services, as distinguished from arrangements for indirect delivery of health services through contracts with providers, shall be exempt from certificate of need review.

(3)

Nothing in ORS 244.050 (Persons required to file statement of economic interest), 431.250 (Federal grants to be handled by Oregon Health Authority), 441.015 (Licensing of facilities and health maintenance organizations) to 441.087 (General inspection of long term care facility), 442.015 (Definitions) to 442.420 (Application for financial assistance) and 442.450 (Exemption from cost review regulations) applies to any decision of a health maintenance organization involving its organizational structure, its arrangements for financing health services, the terms of its contracts with enrolled beneficiaries or its scope of benefits.

(4)

With the exception of certificate of need requirements, when applicable, the licensing and regulation of health maintenance organizations shall be controlled by ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber) and statutes incorporated by reference therein.

(5)

It is the policy of ORS 244.050 (Persons required to file statement of economic interest), 431.250 (Federal grants to be handled by Oregon Health Authority), 441.015 (Licensing of facilities and health maintenance organizations) to 441.087 (General inspection of long term care facility), 442.015 (Definitions) to 442.420 (Application for financial assistance) and 442.450 (Exemption from cost review regulations) to encourage the growth of health maintenance organizations as an alternative delivery system and to provide the facilities for the provision of quality health care to the present and future members who may enroll within their defined service area.

(6)

Intentionally left blank —Ed.

(a)

It is also the policy of ORS 244.050 (Persons required to file statement of economic interest), 431.250 (Federal grants to be handled by Oregon Health Authority), 441.015 (Licensing of facilities and health maintenance organizations) to 441.087 (General inspection of long term care facility), 442.015 (Definitions) to 442.420 (Application for financial assistance) and 442.450 (Exemption from cost review regulations) to consider the special needs and circumstances of health maintenance organizations. Such needs and circumstances include the needs of and costs to members and projected members of the health maintenance organization in obtaining health services and the potential for a reduction in the use of inpatient care in the community through an extension of preventive health services and the provision of more systematic and comprehensive health services. The consideration of a new health service proposed by a health maintenance organization shall also address the availability and cost of obtaining the proposed new health service from the existing providers in the area that are not health maintenance organizations.

(b)

The Oregon Health Authority shall issue a certificate of need for beds, services or equipment to meet the needs or reasonably anticipated needs of members of health maintenance organizations when beds, services or equipment are not available from nonplan providers. [1977 c.751 §56; 1981 c.693 §11; 1995 c.727 §40; 1999 c.581 §9; 2009 c.595 §752]

Source: Section 442.325 — Certificate of need for health care facility of health maintenance organization; exempt activities; policy relating to health maintenance organizations, https://www.­oregonlegislature.­gov/bills_laws/ors/ors442.­html.

442.011
Health Policy and Analytics Division created in Oregon Health Authority
442.015
Definitions
442.310
Findings and policy
442.315
Certificate of need
442.325
Certificate of need for health care facility of health maintenance organization
442.342
Waiver of requirements
442.344
Exemptions from requirements
442.347
Rural hospital required to report certain actions
442.361
Definitions for ORS 442.361, 442.362 and 442.991
442.362
Reporting of proposed capital projects by hospitals and ambulatory surgical centers
442.370
Ambulatory surgery and inpatient discharge abstract records
442.372
Definitions for ORS 442.372 and 442.373
442.373
Health care data reporting by health insurers
442.385
Definitions
442.386
Health Care Cost Growth Target program established
442.392
Uniform payment methodology for hospital and ambulatory surgical center services
442.394
Acceptance by facilities as payment in full
442.396
Attestation of compliance by insurers
442.400
“Health care facility” defined
442.405
Legislative findings and policy
442.420
Application for financial assistance
442.425
Financial reporting systems
442.430
Investigations
442.450
Exemption from cost review regulations
442.460
Information about utilization and cost of health care services
442.463
Annual utilization report
442.470
Definitions for ORS 442.470 to 442.507
442.475
Office of Rural Health
442.480
Rural Health Care Revolving Account
442.485
Responsibilities of Office of Rural Health
442.490
Rural Health Coordinating Council
442.495
Responsibilities of council
442.500
Technical and financial assistance to rural communities
442.502
Determination of size of rural hospital
442.503
Eligibility for economic development grants
442.505
Technical assistance to rural hospitals
442.507
Assistance to rural emergency medical service systems
442.515
Rural hospitals
442.520
Risk assessment formula
442.561
Certifying individuals licensed under ORS chapter 679 for tax credit
442.562
Certifying podiatrists for tax credit
442.563
Certifying certain individuals providing rural health care for tax credit
442.564
Certifying optometrists for tax credit
442.566
Certifying emergency medical services providers for tax credit
442.568
Oregon Health and Science University to recruit persons interested in rural practice
442.570
Primary Care Services Fund
442.601
Definitions
442.602
Community benefit reporting
442.610
Notice of financial assistance policies
442.612
Definitions
442.614
Requirements for financial assistance policies
442.618
Annual reports related to financial assistance policies and nonprofit status
442.624
Establishment of community benefit spending floor
442.630
Community health needs assessment and three-year strategy
442.700
Definitions for ORS 442.700 to 442.760
442.705
Legislative findings
442.710
Application for approval of cooperative program
442.715
Authorized practices under approved cooperative program
442.720
Board of governors for cooperative program
442.725
Annual report of board of governors
442.730
Review and evaluation of report
442.735
Complaint procedure
442.740
Powers of director over action under cooperative program
442.745
Disclosure of confidential information not waiver of right to protect information
442.750
Status of actions under cooperative program
442.755
Rules
442.760
Status to contest order
442.819
Definitions for ORS 442.819 to 442.851
442.820
Oregon Patient Safety Commission
442.825
Funds received by commission
442.830
Oregon Patient Safety Commission Board of Directors
442.831
Powers of board relating to Oregon Patient Safety Reporting Program
442.835
Appointment of administrator
442.837
Oregon Patient Safety Reporting Program
442.839
Commission as central patient safety organization
442.844
Patient safety data
442.846
Patient safety data not admissible in civil actions
442.850
Fees
442.851
Limit on amounts collected to fund Oregon Patient Safety Reporting Program
442.853
Legislative findings
442.854
Definitions
442.855
Oregon Health Care Acquired Infection Reporting Program established
442.856
Health Care Acquired Infection Advisory Committee established
442.860
Comprehensive system of maternity care
442.870
Emergency Medical Services Enhancement Account
442.991
Civil penalties for failure to report proposed capital projects
442.993
Civil penalties for failure to report health care data
442.994
Civil penalty for failure to perform
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