HPA Statute Details

Current HPA Statutes

ArticleRendered

Credentialing, Health Care Practitioners

ORS 441.056, 441.221 to 441.233

441.056 Credentialing telemedicine providers. (1) The Oregon Health Authority shall prescribe by rule the information and documents that a governing body of an originating-site hospital may request for credentialing a telemedicine provider located at a distant-site hospital.

(2) The rules adopted by the authority under subsection (1) of this section must:

(a) Prescribe a standard list of information and documents that shall be provided by a distant-site hospital;

(b) Prescribe a list of information and documents that may be requested by an originating-site hospital in addition to the standard list of information and documents;

(d) Be consistent with all applicable legal and accreditation requirements of an originating-site hospital and the health plans with which the originating-site hospital contracts.

(3) Except as provided in subsection (4) of this section, an originating-site hospital in this state must comply with the rules adopted under this section if the telemedicine provider is located at a distant-site hospital that is located in this state. This section does not prevent hospitals located outside of this state from using or require such hospitals to use the prescribed list of information and documents in credentialing a telemedicine provider.

(4) An originating-site hospital is not limited to the information and documents prescribed by the authority if the originating-site hospital has a delegated credentialing agreement with the distant-site hospital where the telemedicine provider is located and the governing body of the originating-site hospital accepts the recommendation of the medical staff to credential the telemedicine provider.

(5) In the adoption of the rules described in subsections (1) and (2) of this section, the authority shall consult with representatives of distant-site hospitals and originating-site hospitals in this state. Once adopted, the authority may not amend the rules to alter the prescribed lists without first consulting representatives of distant-site hospitals and originating-site hospitals in this state.

(6) This section does not affect the responsibilities of a governing body under ORS 441.055 and does not require a governing body of a hospital to grant privileges to a telemedicine provider. [2013 c.414 §2]

Note: 441.056 was added to and made a part of ORS chapter 441 by legislative action but was not added to any smaller series therein. See Preface to Oregon Revised Statutes for further explanation.

ADVISORY COMMITTEE ON PHYSICIAN CREDENTIALING INFORMATION

441.221 Advisory Committee on Physician Credentialing Information; membership; terms. (1) The Advisory Committee on Physician Credentialing Information is established within the Oregon Health Authority. The committee consists of nine members appointed by the Director of the Oregon Health Authority as follows:

(a) Three members who are health care practitioners licensed by the Oregon Medical Board or representatives of health care practitioners' organizations doing business within the State of Oregon;

(b) Three representatives of hospitals licensed by the Oregon Health Authority; and

(c) Three representatives of health care service contractors that have been issued a certificate of authority to transact health insurance in this state by the Department of Consumer and Business Services.

(2) All members appointed pursuant to subsection (1) of this section shall be knowledgeable about national standards relating to the credentialing of health care practitioners.

(3) The term of appointment for each member of the committee is three years. If, during a member's term of appointment, the member no longer qualifies to serve as designated by the criteria of subsection (1) of this section, the member must resign. If there is a vacancy for any cause, the director shall make an appointment to become immediately effective for the unexpired term.

(4) Members of the committee are not entitled to compensation or reimbursement of expenses. [Formerly 442.800; 2015 c.318 §25]

Note: 441.221 to 441.223 were enacted into law by the Legislative Assembly but were not added to or made a part of ORS chapter 441 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.

441.222 Committee recommendations. (1) The Advisory Committee on Physician Credentialing Information shall develop and submit recommendations to the Director of the Oregon Health Authority for the collection of uniform information necessary for credentialing organizations to credential health care practitioners seeking designation as a participating provider or member of a credentialing organization. The recommendations must specify:

(a) The content and format of a credentialing application form; and

(b) The content and format of a recredentialing application form.

(2) The committee shall meet at least once every calendar year to review the uniform credentialing information and to assure the director that the information complies with credentialing standards developed by national accreditation organizations and applicable regulations of the federal government.

(3) The Oregon Health Authority shall provide the support staff necessary for the committee to accomplish its duties. [Formerly 442.805; 2015 c.318 §26]

Note: See note under 441.221.

441.223 Implementation of committee recommendations; rules. (1) Upon receiving the recommendations of the Advisory Committee on Physician Credentialing Information, the Oregon Health Authority shall:

(a) Adopt administrative rules in a timely manner, as required by the Administrative Procedures Act, for the purpose of effectuating the provisions of ORS 441.221 to 441.223;

(b) Consult with the advisory group convened under ORS 441.232 to review the recommendations and obtain advice on the rules; and

(c) Ensure that the rules adopted by the Oregon Health Authority are identical and are consistent with the recommendations developed pursuant to ORS 441.222 for affected credentialing organizations.

(2) The uniform credentialing information required pursuant to the administrative rules of the Oregon Health Authority represents the minimum uniform credentialing information required by the affected credentialing organizations. Except as provided in subsection (3) of this section, a credentialing organization may request additional credentialing information from a health care practitioner for the purpose of completing credentialing procedures used by the credentialing organization to credential health care practitioners.

(3) In credentialing a telemedicine provider, a hospital is subject to the requirements prescribed by rule by the authority under ORS 441.056. [Formerly 442.807]

Note: See note under 441.221.

ELECTRONIC CREDENTIALING INFORMATION

441.224 Definitions for ORS 441.224 to 441.233. As used in ORS 441.224 to 441.233:

(1) "Credentialing information" means information necessary to credential or recredential a health care practitioner.

(2) "Credentialing organization" means a hospital or other health care facility, physician organization or other health care provider organization, coordinated care organization, business organization, insurer or other organization that credentials health care practitioners.

(3) "Health care practitioner" means an individual authorized to practice a profession related to the provision of health care services in this state for which the individual must be credentialed.

(4) "Health care regulatory board" means a board or other agency that authorizes individuals to practice a profession related to the provision of health care services for which the individual must be credentialed. [2013 c.603 §2]

441.225 [Repealed by 1971 c.727 §203]

441.226 Electronic credentialing information program.

(1)(a) The Oregon Health Authority, in consultation with the advisory work group convened under ORS 441.232, shall establish a program for the purpose of providing to a credentialing organization access to information that is necessary to credential or recredential a health care practitioner.

(b) To fulfill the requirements of this subsection, the authority shall establish and operate an electronic system through which credentialing information may be submitted to an electronic database and accessed. The system must operate and be accessible by credentialing organizations, health care practitioners and health care regulatory boards 24 hours a day, seven days a week. The authority may contract with a private entity to ensure the effective establishment and operation of the system.

(c) To the greatest extent practicable, the electronic system shall use the most accessible and current technology available.

(2) In consultation with the advisory work group convened under ORS 441.232, the authority shall adopt rules for the operation of the electronic system, including:

(a) Identification of the type of information that is necessary to credential or recredential each type of health care practitioner;

(b) Processes by which a health care practitioner or health care regulatory board submits credentialing information to the authority or an entity that has entered into a contract with the authority under subsection (1)(b) of this section;

(c) Processes, as required by recognized state and national credentialing standards, by which credentialing information submitted under ORS 441.228 is verified;

(d) Processes by which a credentialing organization, health care practitioner or health care regulatory board may electronically access the database;

(e) Processes by which a health care practitioner may attest that the credentialing information in the electronic database is current;

(f) The purposes for which credentialing information accessed by a credentialing organization or health care regulatory board may be used; and

(g) The imposition of fees, not to exceed the cost of administering ORS 441.224 to 441.233, on health care practitioners who submit credentialing information to the database and credentialing organizations that access the database.

(3) All information, except for general information used for directories, as defined by the authority by rule, that is received, kept and maintained in the database under this section is exempt from public disclosure under ORS 192.410 to 192.505. [2013 c.603 §3]

441.227 [1965 c.403 §2; 1969 c.343 §5; repealed by 1971 c.727 §203]

441.228 Submission of credentialing information; civil immunity. (1)(a) As a condition of being authorized to practice a profession in this state, a health care practitioner or designee must submit to the Oregon Health Authority, an entity that has entered into a contract with the authority under ORS 441.226 (1)(b) or a health care regulatory board the credentialing information identified by the authority under ORS 441.226 (2)(a).

(b) A health care practitioner that, in good faith, submits credentialing information under this subsection is immune from civil liability that might otherwise be incurred or imposed with respect to the submission of that credentialing information.

(2) The authority may require a health care regulatory board, after consulting with the health care regulatory board, to provide or supplement the credentialing information identified by the authority under ORS 441.226 (2)(a).

(3)(a) A credentialing organization shall obtain from the authority, or an entity that has entered into a contract with the authority under ORS 441.226 (1)(b), the credentialing information of the health care practitioner that is kept and maintained in the electronic database described in ORS 441.226. A credentialing organization may not request credentialing information from a health care practitioner if the credentialing information is available through the database. However, nothing in ORS 441.224 to 441.233 shall prevent a credentialing organization from requesting additional credentialing information from a health care practitioner for the purpose of completing credentialing procedures for the health care practitioner used by the credentialing organization.

(b) A credentialing organization that, in good faith, uses credentialing information provided under this subsection for the purposes established by the authority under ORS 441.226 (2)(e) is immune from civil liability that might otherwise be incurred or imposed with respect to the use of that credentialing information. [2013 c.603 §4]

441.229 Exemption from electronic credentialing information program. A prepaid group practice health plan that serves at least 200,000 members in this state and that has been issued a certificate of authority by the Department of Consumer and Business Services may petition the Director of the Oregon Health Authority to be exempt from the requirements of ORS 441.224 to 441.233. The director may award the petition if the director determines that subjecting the health plan to ORS 441.224 to 441.233 is not cost-effective. If a petition is awarded under this section, the exemption also applies to any health care facilities and health care provider groups associated with the health plan. [2013 c.603 §5]

441.230 [Amended by 1965 c.403 §3; 1969 c.343 §6; repealed by 1971 c.727 §203]

441.232 Advisory group. At least once per year, the Oregon Health Authority shall convene an advisory group consisting of individuals who represent credentialing organizations, health care practitioners and health care regulatory boards to review and advise the authority on the implementation of ORS 441.224 to 441.233 and on the standard credentialing application used in this state. [2013 c.603 §7]

441.233 Rules. The Director of the Oregon Health Authority shall adopt rules necessary for the administration of ORS 441.224 to 441.233. [2013 c.603 §6]

Note: Section 2, chapter 297, Oregon Laws 2015, provides:

Sec. 2. (1) As used in this section, "credentialing information," "credentialing organization," "health care practitioner" and "health care regulatory board" have the meanings given those terms in section 2, chapter 603, Oregon Laws 2013 [441.224].

(2) Notwithstanding section 4 (1), chapter 603, Oregon Laws 2013 [441.228 (1)], a health care practitioner is not required to submit credentialing information to the program established by the Oregon Health Authority under section 3, chapter 603, Oregon Laws 2013 [441.226], and submission of the credentialing information is not a condition of being authorized to practice a profession in this state, until both of the following have occurred:

(a) The authority has established an operational electronic system through which credentialing information may be submitted; and

(b) The date has passed by which the authority requires by rule that type of health care practitioner to submit the credentialing information.

(3) Before adopting rules under subsection (2) of this section, the authority shall consult the advisory work group described in section 7, chapter 603, Oregon Laws 2013 [441.232], about the date by which each type of health care practitioner should be required to submit the credentialing information.

(4) Notwithstanding ORS 183.335 (1), notice of a rule adopted under subsection (2) of this section must be provided at least six months before the effective date of the rule:

(a) By electronic mail to credentialing organizations represented in the advisory work group described in section 7, chapter 603, Oregon Laws 2013; and

(b) By electronic mail to the health care regulatory board that is responsible for regulating the type of health care practitioner to whom the rule applies. [2015 c.297 §2]

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