Or. Admin. R. 409-025-0150 - Compliance and Enforcement
(1)
Unless approved by a waiver or extension , failure to comply with general
reporting requirements includes but is not limited to:
(a) Failure to submit data files for a
required line of business; or
(b)
Submitting health information for an excluded line of business.
(2) Unless approved by a waiver or
exemption , failure to comply with data file requirements includes but is not
limited to:
(a) Submitting a data file in an
unapproved layout;
(b) Submitting a
data element in an unapproved format;
(c) Submitting a data element with unapproved
coding;
(d) Failure to submit a
required data element; or
(e)
Failure to comply with validation and quality control efforts, including
resubmitting or correcting data as requested by the Authority.
(3) Unless approved by a waiver or
extension , failure to comply with data submission requirements includes but is
not limited to:
(a) Failure to maintain an
active user in the data vendor reporting portal;
(b) Failure to submit test files as specified
by the data vendor ;
(c) Submitting
data files later than five days after the submission due date as detailed in
Data Submission Schedule;
(d)
Rejection of a data file by the data vendor that is not resubmitted or
corrected by the submitter within 14 calendar days from notification of error;
or
(e) Transmitting data files
using an unapproved process.
(4) The Authority shall provide mandatory
reporters written notification of each failure to comply prior to imposing a
civil penalty under this rule. Mandatory reporters will have 30 calendar days
to come into compliance.
(5) The
Authority may impose civil penalties against mandatory reporters for each
failure to comply that is not resolved within 30 calendar days of written
notification. If a mandatory reporter does not come into compliance within 30
days of written notification, penalties will be assessed starting from the date
the mandatory reporter was notified of non-compliance. Pursuant to ORS
442.993, the Authority adopts
the following schedule of civil penalties:
(a) Up to $400.00 per day for violations of
OAR 409-025-0150(1);
(c) Up to
$200.00 per day for violations of OAR 409-025-0150(3).
(6) If a mandatory reporter was issued a
final order imposing civil penalties within 24 months from the date the
Authority issues a notice of intent to impose a civil penalty, the Authority
may impose an additional $100.00 per day for each of the category of violations
listed in section (5) of this rule.
(7) If a mandatory reporter has made
documented efforts to comply with these rules, the Authority may consider this
a mitigating factor before imposing civil penalties against the mandatory
reporter .
Notes
To view tables referenced in rule text, click here to view rule.
Statutory/Other Authority: ORS 442.466 & 442.993
Statutes/Other Implemented: ORS 442.464, 442.993 & 442.466
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