Oregon Administrative Rules Chapter 943 - OREGON HEALTH AUTHORITY
Oregon Administrative Rules (OAR) Chapter 943 details the extensive regulations governing the Oregon Health Authority (OHA). The OHA is a broad state agency responsible for improving the lifelong health of Oregonians, increasing the quality and availability of health care, and lowering the cost of care.
Given the wide scope of the OHA's responsibilities, Chapter 943 covers a diverse range of topics, reflecting the complexity of administering health services for an entire state. Here's a general overview of the types of divisions found within OAR Chapter 943:
Division 1: Procedural Rules: These are standard administrative rules that outline how the OHA conducts its business, including rulemaking processes, public meeting procedures, and general administrative functions.
Division 3: Public Record Fees: Specifies the fees associated with requesting and obtaining public records from the OHA, in accordance with Oregon public records law.
Division 5: Individual Rights: This division addresses the rights of individuals interacting with the health care system and the OHA, which may include aspects of patient rights, access to services, and non-discrimination.
Division 7: Criminal History Checks: Outlines the requirements and procedures for criminal history checks for individuals working in certain health-related fields or with vulnerable populations, to ensure safety and prevent abuse.
Division 12: Restricting Access to Oregon Health Authority Premises and Employees: These rules govern conduct on OHA premises and interactions with OHA employees, likely for the safety and security of staff and visitors.
Division 14: Privacy and Confidentiality: A critical division that establishes the rules for protecting sensitive health information (PHI) and ensuring the confidentiality of patient data, in compliance with state and federal privacy laws (like HIPAA). This covers how information can be collected, used, and disclosed.
Division 45: Abuse Investigations and Safety: Addresses the procedures and protocols for investigating allegations of abuse, neglect, or exploitation within health care settings, and measures to ensure patient safety.
Division 60: Public Contracting and Procurement: Details the rules for how the OHA procures goods and services, including requirements for competitive bidding, contract management, and ethical considerations.
Division 70: Race, Ethnicity, Language, and Disability Demographic Data Collection Standards: This division underscores OHA's commitment to health equity by setting standards for the collection of demographic data. This data helps OHA identify health disparities and tailor programs to better serve diverse populations.
Division 90: Cultural Competency Continuing Education for Healthcare Professionals: Reflects the OHA's emphasis on culturally competent care, requiring healthcare professionals to undertake continuing education to better understand and serve diverse patient populations.
Division 120: Provider Rules: This is a broad category that encompasses regulations for various healthcare providers that interact with OHA programs, such as the Oregon Health Plan (Medicaid). These rules would cover:
Provider Enrollment and Participation: Requirements for providers to enroll in OHA programs (like the Oregon Health Plan) and maintain their participation.
Billing and Reimbursement: Rules for how providers can bill for services and how they are reimbursed.
Quality Standards: Requirements for the quality of care and services provided.
Sanctions and Disciplinary Actions: Procedures for addressing non-compliance by providers.
Overall Functions and Purpose of the Oregon Health Authority (as reflected in OAR Chapter 943):
The OHA plays a central role in Oregon's healthcare system. Its functions, governed by these administrative rules, include:
Administering the Oregon Health Plan (OHP): Oregon's Medicaid program, providing health coverage to low-income individuals and families.
Public Health Initiatives: Protecting and promoting the health of the public through programs addressing communicable diseases, environmental health, maternal and child health, chronic disease prevention, and emergency preparedness.
Health System Transformation: Leading efforts to reform Oregon's healthcare system, including the development of Coordinated Care Organizations (CCOs) which aim to deliver integrated physical, mental, and dental health care.
Behavioral Health Services: Overseeing mental health and substance use disorder services.
Health Policy and Analytics: Developing health policy, collecting and analyzing health data, and evaluating the effectiveness of health programs.
Licensing and Certification: While some licensing is done by the Health Licensing Office (which is part of OHA), OHA itself sets overarching standards for various healthcare facilities and services.
Promoting Health Equity: Working to eliminate health disparities and ensure that all Oregonians have the opportunity to achieve optimal health, regardless of their background.
In essence, OAR Chapter 943 provides the regulatory backbone for the Oregon Health Authority's broad mandate to improve the health and well-being of all Oregonians through comprehensive health policies, programs, and services.
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