Or. Admin. R. 850-005-0185 - Peer Review

(1) If the Board directs, peer review will occur upon submission of a request for review by a patient, his/her representative, insurer or health care provider, an agency, or the Board itself. This request must be made in writing and submitted with all available information and documentation. The Board shall establish criteria for screening requests for peer review. The Board shall have the authority to establish a fee to assist in defraying administrative costs of performing the review.

(2) The Peer Review Investigatory Committee may request an informal interview with the doctor(s) being reviewed and, when appropriate, may request the opinion of other health care providers for reviews involving particular area of practice. When required to travel, the members shall be paid mileage and per diem at the state rate.

(3) Any member(s) of the Peer Review Committee shall disqualify him/herself from participation in a case investigation for close personal and/or professional involvement or association with the involved doctor(s), patient, patient's representative and the insurer or professional competition in the community with the involved doctor(s). Members shall also be disqualified for lack of impartiality. The doctor(s) being reviewed may protest being reviewed by a specific peer review member, request the presence of a Board member(s) or be given the opportunity to be accompanied by legal counsel.

(4) The Peer Review Investigatory Committee shall consider all files and records submitted to it by the Board. These records shall be compiled in their completeness before submission to each Peer Review member. The Committee shall also consider any written and/or oral comments by doctor(s) being reviewed and the involved patient. The Committee shall meet, complete the review and submit a written report to the Board within 60 days of the submission of the case to the Peer Review Committee. This report should be made in the presence of the full committee, or copies shall be sent to the absent members for their written approval prior to submission to the Board. The report shall include, but not be limited to, a brief statement of the facts of the case, any violation of ORS Chapter 685, the necessity, efficacy and/or appropriateness of any part of the care provided and any comments which may assist the Board in taking appropriate action. An annual summary of the findings of the Peer Review Investigatory Committee shall be prepared and submitted to the Board.

(5) The peer review process shall be governed by ORS Chapter 183 and 685.205. The evaluations and recommendations of the Committee shall be submitted and placed in the files of the Board and shall not be subject to the public disclosure or admissible as evidence in any judicial proceeding. Only in the case where the Board finds any violation of ORS Chapter 685, and following a formal hearing, shall the party who submitted the request be notified of the Board's specific findings. The doctor(s) being reviewed must receive a certified copy of the Peer Review Investigatory Committee's findings. The Board shall dismiss immediately any Peer Review member found to have violated ORS Chapter 685.

(6) To provide active supervision over the conduct of the peer review committee a board member shall serve as a member of the peer review committee.

Notes

Or. Admin. R. 850-005-0185

NE 1-1990, f. & cert. ef. 4-13-90; BNE 3-2002(Temp), f. & cert. ef. 6-11-02 thru 12-8-02; BNE 5-2002, f. & cert. ef. 10-10-02; Renumbered from 850-030-0185, BNE 8-2005, f. & cert. ef. 10-27-05

Stat. Auth.: ORS 685.125

Stats. Implemented: ORS 685.205