ORS 414.736¹
Definitions

As used in this section and ORS 414.725 (Prepaid managed care health services contracts), 414.737 (Mandatory enrollment in prepaid managed care health services organization), 414.738 (Use of physician care organizations), 414.739 (Circumstances under which fully capitated health plan may contract as physician care organization), 414.740 (Contracts with certain prepaid group practice health plan), 414.741 (Determination of benchmarks for setting per capita rates), 414.742 (Payment for mental health drugs), 414.743 (Payment to noncontracting hospital by fully capitated health plan) and 414.744 (Pharmacy benefit manager to manage prescription drug benefits):

(1) "Designated area" means a geographic area of the state defined by the Department of Human Services by rule that is served by a prepaid managed care health services organization.

(2) "Fully capitated health plan" means an organization that contracts with the Department of Human Services on a prepaid capitated basis under ORS 414.725 (Prepaid managed care health services contracts) to provide an adequate network of providers to ensure that the health services provided under the contract are reasonably accessible to enrollees.

(3) "Physician care organization" means an organization that contracts with the Department of Human Services on a prepaid capitated basis under ORS 414.725 (Prepaid managed care health services contracts) to provide an adequate network of providers to ensure that the health services described in ORS 414.705 (Definitions for ORS 414.705 to 414.750) (1)(b), (c), (d), (e), (g) and (j) are reasonably accessible to enrollees. A physician care organization may also contract with the department on a prepaid capitated basis to provide the health services described in ORS 414.705 (Definitions for ORS 414.705 to 414.750) (1)(k) and (L).

(4) "Prepaid managed care health services organization" means a managed physical health, dental, mental health or chemical dependency organization that contracts with the Department of Human Services on a prepaid capitated basis under ORS 414.725 (Prepaid managed care health services contracts). A prepaid managed care health services organization may be a dental care organization, fully capitated health plan, physician care organization, mental health organization or chemical dependency organization. [2003 c.810 §2]

Note: 414.736 (Definitions) to 414.744 (Pharmacy benefit manager to manage prescription drug benefits) were added to and made a part of 414.705 (Definitions for ORS 414.705 to 414.750) to 414.750 (Authority of Legislative Assembly to authorize services for other persons) by legislative action but were not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.

1 Legislative Counsel Committee, CHAPTER 414—Medical Assistance, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­414.­html (2007) (last ac­cessed Feb. 12, 2009).
 
2 Legislative Counsel Committee, Annotations to the Oregon Revised Stat­utes, Cumulative Supplement - 2007, Chapter 414, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­414ano.­htm (2007) (last ac­cessed Feb. 12, 2009).
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.
Currency Information