Or. Admin. Code § 333-010-0105

Current through Register Vol. 63, No. 10, October 1, 2024

Section 333-010-0105 - Definitions

(1) "Agency number" means the administrative number assigned to the service provider by the Center for Prevention and Health Promotion (Center) for identification as a ScreenWise Breast and Cervical Cancer services (ScreenWise BCC) provider.

(2) "Ancillary provider" means a provider that performs services beyond the scope of an enrolling provider. Ancillary providers may include but is not limited to laboratories, imaging centers, surgeons and surgical facilities, and hospitals.

(3) "Approved medical services agreement" means the completed ScreenWise BCC agreement, submitted to and approved by the Center for Prevention and Health Promotion.

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

(5) "BCCTP" means the Breast and Cervical Cancer Treatment Program. ORS 414.534, 414.536.

(6) "Care coordination or case management" means that a client is provided with services, results, follow-up recommendations, and active tracking of progress towards follow-up recommendations.

(7) "Center" means the Center for Prevention and Health Promotion, the office within the Oregon Health Authority that administers the ScreenWise BCC.

(8) "CLIA" means the federal Clinical Laboratory Improvement Amendments of 1988, establishes quality standards for all laboratory testing to ensure the accuracy, reliability and timeliness of patient test results, and allows for certification of clinical laboratories operating in accordance with these federal amendments.

(9) "Client" means a person of any age or gender who is enrolled in and receives screening or diagnostic services from the ScreenWise BCC.

(10) "Enrolling provider" means a provider that enrolls a client into the ScreenWise BCC, provides care coordination for the client and timely data submission to ScreenWise BCC.

(11) "FPL" means the federal poverty level guidelines established each year by the Department of Health and Human Services, used to determine eligibility for ScreenWise BCC and other federally funded programs.

(12) "HIPAA" means the Health Insurance Portability and Accountability Act.

(13) "ScreenWise BCC" means the ScreenWise program component that provides statewide breast and cervical cancer screening and diagnostic services to eligible clients, that is administered by the Center for Prevention and Health Promotion within the Oregon Health Authority.

(14) "ScreenWise BCC Provider Network" means the combination of all contracted ScreenWise providers, including enrolling and ancillary providers.

(15) "Service provider" or "provider" means a licensed health care provider operating within a scope of practice, who is authorized by the Center to bill for breast and cervical cancer screening and diagnostic services for eligible clients.

(16) "Site number" means the administrative number assigned to the provider by the Center for identification of the geographic location of each ScreenWise BCC provider.

(17) "Underinsured" means that health insurance does not fully cover breast and cervical cancer screening services or that out-of-pocket cost sharing for diagnostic services would pose a financial hardship.

Or. Admin. Code § 333-010-0105

PH 9-2008, f. & cert. ef. 6-16-08; PH 5-2011(Temp), f. & cert. ef. 7-1-11 thru 12-27-11; PH 11-2011, f. & cert. ef. 10-27-11; PH 1-2012, f. & cert. ef. 1-17-12; PH 13-2014(Temp), f. & cert. ef. 4-22-14 thru 10-19-14; PH 28-2014, f. & cert. ef. 10-10-14; PH 11-2016, f. & cert. ef. 4/1/2016

Stat. Auth.: ORS 413.042

Stats. Implemented: 413.042