ORS 415.055¹
Confidentiality of complaints
  • exceptions
  • publication of annual statistical report of complaints against all CCOs

(1) A complaint made to the Oregon Health Authority against a coordinated care organization for a violation of ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care) or rules adopted pursuant to ORS 415.011 (Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers), and the record of the complaint, is confidential and may not be disclosed except as provided in ORS 413.175 (Prohibition on disclosure of information) or 414.607 (Use and disclosure of member information). The complaint, and the record of the complaint, may not be used in any action, suit or proceeding except to the extent the authority considers necessary in prosecuting apparent violations of ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care), rules adopted pursuant to ORS 415.011 (Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers) or other law.

(2) Data gathered pursuant to an investigation by the authority of a complaint is confidential, may not be disclosed except as provided in ORS 413.175 (Prohibition on disclosure of information) and 414.607 (Use and disclosure of member information) and may not be used in any action, suit or proceeding except to the extent the authority considers necessary in investigating or prosecuting apparent violations of ORS 415.012 (Definitions for ORS 415.012 to 415.430) to 415.430 (Liability of member of CCO to pay provider for cost of care), rules adopted pursuant to ORS 415.011 (Oregon Health Authority regulation of financial solvency of CCOs to align with regulation of domestic insurers) or other law.

(3) Notwithstanding subsections (1) and (2) of this section, the authority shall establish by rule a method for publishing an annual statistical report containing the coordinated care organization’s name and the number, percentage, type and disposition of complaints the authority receives against each coordinated care organization that contracts with the authority. [2019 c.478 §12]

1 Legislative Counsel Committee, CHAPTER 415—Financial Regulation of Coordinated Care Organizations, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors415.­html (2019) (last ac­cessed May 16, 2020).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
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