Current through Register Vol. 63, No. 9, September 1, 2024
(1) For purposes of
this rule:
(a) "Health care facility" means:
(A) A hospital;
(B) An ambulatory surgical center;
(C) A freestanding birthing center;
(D) An outpatient renal dialysis facility;
or
(E) An extended stay
center.
(b) "Reportable
affiliated clinic" means an outpatient clinic located in Oregon that:
(A) Is operating under the common control of
a hospital; or
(B) Is owned in
whole or part by the hospital; or
(C) Is operating under the same brand of the
hospital.
(2)
A hospital or health system designee must submit a health care facility and
reportable affiliated clinic report using the Hospital Facility and Clinic
Report form (form HFCR) to the Authority, annually, by June 30 of each calendar
year. The report shall identify its health care facilities and reportable
affiliated clinics on form HFCR and provide the following:
(a) The health care facility name and street
address for the facility location;
(b) The reportable affiliated clinic name and
street address for the clinic location;
(c) The non-profit status of each health care
facility or reportable affiliated clinic; and
(d) An attestation, signed by an officer of
the hospital, that the hospital's financial assistance policy as developed
under ORS 442.614 has been posted in the
health care facilities and reportable affiliated clinics, and has been made
available to patients of the facility and reportable affiliated
clinic.
(3) Effective
for hospital fiscal years that begin on or after January 1, 2025, hospitals
must submit the Hospital Financial Assistance Report form (form HFAR) no later
than 150 days after the end of the hospital's fiscal year, for certain
financial assistance data from the most recently completed fiscal year. Data on
form HFAR must include:
(a) Total number of
financial assistance applications received in the fiscal year, and of the
received applications, the number approved and denied by the following payer
types:
(A) Uninsured;
(B) Medicare and Medicare
Advantage;
(C) State medical
assistance programs including out-of-state Medicaid;
(D) Commercial or private health insurance;
and
(E) All other payers.
(b) Total number of patients who
received cost adjustments based on:
(A)
Completing a hospital's financial assistance application; and
(B) Without completing a hospital's financial
assistance application, but instead as a result of the hospital's presumptive
eligibility process as specified in OAR
409-023-0120.
(c) Total number of patient
accounts referred to a debt collector or collection agency;
(d) Total number of patient accounts in which
extraordinary collection activities (ECA) occurred, listed by the following
categories, as described in 26 C.F.R. 1.501(r)-6(b) :
(A) Selling of an individual's debt to
another party (except for those sales not considered an ECA as described in 26
C.F.R. 1.501(r)-6(b)(2));
(B)
Reporting adverse information about the individual to consumer credit reporting
agencies or credit bureaus;
(C)
Deferring or denying, or requiring a payment before providing, medically
necessary care because of an individual's nonpayment of one or more bills for
previously provided care covered under the hospital's financial assistance
policy, as described in 26 C.F.R. 1.501(r)-6(b)(iii); and
(D) Taking actions that require a legal or
judicial process including, but not limited to, liens, judgements,
garnishments, foreclosures, or other action related to collection of a debt
owed to the hospital as described in 26 CFR 1.501(r)-6(b)(iv)(A)-(G).
(e) The average and median per
person debt, as well as the total amount of debt owed to the hospital by
patients whose accounts were either placed in collections or referred to a
collection agency during the reporting period.
(4) The Authority shall provide the necessary
data reporting templates and make them available on its website no later than
September 30th of each year for the upcoming fiscal year reporting.
(5) Data collected on form HFCR and form HFAR
shall be made publicly available on the Hospital Reporting Program of the
Authority's website. Prior to posting on its website, the Authority shall
suppress information as necessary to protect patient confidentiality in
accordance with applicable laws and regulations, as well as with the
Authority's policies regarding small number reporting.
(6) A hospital that fails to report as
required in OAR 409-023-0115 may be subject to a
civil penalty not to exceed $500 per day.
