Oregon Administrative Rules
Chapter 409 - OREGON HEALTH AUTHORITY, HEALTH POLICY AND ANALYTICS
Division 70 - HEALTH CARE MARKET OVERSIGHT PROGRAM
Section 409-070-0005 - Definitions

(1) "Administrative services" means support and administration services, outsourced and subcontracted services and other equivalent services and servicing arrangements relating to, supporting or facilitating the provision of patient care and services.

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

(3) "AVP methodologies" means the advanced value-based payment models (3A and higher) described in the Oregon Value-Based Payment Compact (June 28, 2021).

(4) "Business entity" has the meaning given in ORS 731.116.

(5) "Carrier" means:

(6) "Charitable organization" has the meaning given in ORS 128.620.

(7) "Comprehensive management services" means a person provides all or substantially all the personnel, or manages all or substantially all the operations, of a health care entity.

(8) "Control" means the direct or indirect power to manage a legal entity or set the legal entity's policies, whether by owning voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position or corporate office.

(9) "Coordinated care organization" has the meaning given in ORS 414.025.

(10) "Corporate affiliation" means a health care entity controls, is controlled by, or is under common control with another legal entity.

(11) "Covered transaction" means a transaction described in OAR 409-070-0010.

(12) "Department" means the Department of Consumer and Business Services.

(13) "Domestic health insurer" means an insurer as defined in ORS 731.106 or a health care service contractor as defined in ORS 750.005 that is formed under the laws of this state and has a certificate of authority from the Department to insure personal health risks, or pay for or provide health care services, whether in the form of indemnity insurance, managed care products or any other form or type of individual or group health insurance or health care service contract.

(14) In accordance with ORS 415.500(2), "essential services" means:

(15) In accordance with ORS 415.500(3), "health benefit plan" has the meaning given in ORS 743B.005.

(16) In accordance with ORS 415.500(4)(a), "health care entity" includes all of the following:

(17) In accordance with ORS 415.500(4)(b), "health care entity" does not include:

(18) "Health equity" means a health system having and offering infrastructure, facilities, services, geographic coverage, affordability and all other relevant features, conditions and capabilities that will provide all people with the opportunity and reasonable expectation that they can reach their full health potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or their socially determined circumstances.

(19) "Hospital" has the meaning given in ORS 442.015.

(20) "Hospital system" means:

(21) "Independent practice association" has the meaning given in ORS 743B.001.

(22) "Material change transaction" means a covered transaction that is material under the materiality standards set forth in OAR 409-070-0015.

(23) In accordance with ORS 415.500(8), "net patient revenue" means the total amount of income, after allowance for contractual amounts, charity care and bad debt, received for patient care and services, including:

(24) "Person" has the meaning given in ORS 731.116.

(25) "Program website" means the Authority's website for the Health Care Market Oversight Program, currently at https://www.oregon.gov/oha/HPA/HP/Pages/health-care-market-oversight.aspx.

(26) "Provider" means a person licensed, certified or otherwise authorized or permitted by laws of Oregon to administer or provide medical or mental health services in the ordinary course of business or practice of a profession.

(27) In accordance with ORS 415.500(9), "revenue" of a party to the transaction means:

(28) "Services that are essential to achieve health equity" means:

(29) "Term sheet" means a memorandum of understanding or letter of intent setting forth the negotiated terms and conditions of the proposed transaction in reasonable detail, signed by the parties to a proposed transaction, or any other equivalent document that sets forth an agreement in principle for a proposed transaction.

(30) "These rules" means the rules set forth in OAR 409-070-0000 through OAR 406-070-0085.

(31) "Voting security" means a security that entitles the owner or holder of the security to vote at a meeting of shareholders, a membership interest having voting rights in a limited liability company or nonprofit corporation, a partnership interest having voting rights in a limited or general partnership or any other type of instrument that confers on the holder of the instrument voting rights in the governance of a legal entity. A "voting security" also includes a security that is convertible into a voting security or that is evidence of a right to acquire a voting security.