Or. Admin. Code § 409-055-0010 - Definitions

The following definitions apply to OAR 409-055-0000 to 409-055-0090:

(1) "Authority" means the Oregon Health Authority.

(2) "NCQA" means National Committee for Quality Assurance.

(3) "Patient Centered Medical Home (PCMH)" means a practice or provider who has been recognized as such by the National Committee for Quality Assurance.

(4) "Patient-Centered Primary Care Home (PCPCH)" means a health care team or clinic as defined in ORS 414.655, meets the standards pursuant to OAR 409-055-0040, and has been recognized through the process pursuant to OAR 409-055-0040.

(5) "Personal Health Information" means demographic information, medical history, test and laboratory results, insurance information and other data that is collected by a health care professional to identify an individual and determine appropriate care.

(6) "Practice" means an individual, facility, institution, corporate entity, or other organization which provides direct health care services or items, also termed a performing provider, or bills, obligates and receives reimbursement on behalf of a performing provider of services, also termed a billing provider (BP). The term provider refers to both performing providers and BP(s) unless otherwise specified.

(7) "Program" means Patient-Centered Primary Care Home Program.

(8) "Program website" means www.primarycarehome.oregon.gov.

(9) "Provider" means an individual, facility, institution, corporate entity, or other organization which provides direct health care services or items, also termed a performing provider, or bills, obligates and receives reimbursement on behalf of a performing provider of services, also termed a billing provider (BP). The term provider refers to both performing providers and BP(s) unless otherwise specified.

(10) "Recognition" means the process through which the Authority determines if a practice has met the Oregon Patient-Centered Primary Care Home Standards.

(11) "Recognized" means that the Authority has affirmed that a practice meets the Oregon Patient-Centered Primary Care Home Standards.

(12) "Tier" means the level of Patient-Centered Primary Care Home at which the Authority has scored a practice.

(13) "Verification" means the process that the Authority shall conduct to ensure that a practice has submitted accurate information to the Authority for purposes of Patient-Centered Primary Care Home recognition.

(14) "Health Equity Designation" means a designation assigned to Patient-Centered Primary Care Homes meeting specific PCPCH measures.

Notes

Or. Admin. Code § 409-055-0010

OHP 6-2011(Temp), f. 9-29-11, cert. ef. 10-1-11 thru 3-15-12; OHP 2-2012, f. 2-29-12, cert. ef. 3-1-12; OHP 2-2015, f. 1-16-15, cert. ef. 2/1/2015; OHP 10-2015(Temp), f. 12-29-15, cert. ef. 1-1-16 thru 6-24-16; OHP 9-2016, f. & cert. ef. 5/13/2016; OHP 15-2018, amend filed 11/29/2018, effective 12/1/2018; OHP 3-2023, amend filed 11/30/2023, effective 11/30/2023

Statutory/Other Authority: ORS 413.042, 413.259, 414.655

Statutes/Other Implemented: ORS 413.259, 413.260, 414.655