As used in ORS 192.518 to 192.529:
(1) “Authorization” means a document written in plain language that contains at least the following:
(a) A description of the information to be used or disclosed that identifies the information in a specific and meaningful way;
(b) The name or other specific identification of the person or persons authorized to make the requested use or disclosure;
(c) The name or other specific identification of the person or persons to whom the covered entity may make the requested use or disclosure;
(d) A description of each purpose of the requested use or disclosure, including but not limited to a statement that the use or disclosure is at the request of the individual;
(e) An expiration date or an expiration event that relates to the individual or the purpose of the use or disclosure;
(f) The signature of the individual or personal representative of the individual and the date;
(g) A description of the authority of the personal representative, if applicable; and
(h) Statements adequate to place the individual on notice of the following:
(A) The individual’s right to revoke the authorization in writing;
(B) The exceptions to the right to revoke the authorization;
(C) The ability or inability to condition treatment, payment, enrollment or eligibility for benefits on whether the individual signs the authorization; and
(D) The potential for information disclosed pursuant to the authorization to be subject to redisclosure by the recipient and no longer protected.
(2) “Covered entity” means:
(a) A state health plan;
(b) A health insurer;
(c) A health care provider that transmits any health information in electronic form to carry out financial or administrative activities in connection with a transaction covered by ORS 192.518 to 192.529; or
(d) A health care clearinghouse.
(3) “Health care” means care, services or supplies related to the health of an individual.
(4) “Health care operations” includes but is not limited to:
(a) Quality assessment, accreditation, auditing and improvement activities;
(b) Case management and care coordination;
(c) Reviewing the competence, qualifications or performance of health care providers or health insurers;
(d) Underwriting activities;
(e) Arranging for legal services;
(f) Business planning;
(g) Customer services;
(h) Resolving internal grievances;
(i) Creating de-identified information; and
(j) Fundraising.
(5) “Health care provider” includes but is not limited to:
(a) A psychologist, occupational therapist, clinical social worker, professional counselor or marriage and family therapist licensed under ORS chapter 675 or an employee of the psychologist, occupational therapist, clinical social worker, professional counselor or marriage and family therapist;
(b) A physician, podiatric physician and surgeon, physician assistant or acupuncturist licensed under ORS chapter 677 or an employee of the physician, podiatric physician and surgeon, physician assistant or acupuncturist;
(c) A nurse or nursing home administrator licensed under ORS chapter 678 or an employee of the nurse or nursing home administrator;
(d) A dentist licensed under ORS chapter 679 or an employee of the dentist;
(e) A dental hygienist or denturist licensed under ORS chapter 680 or an employee of the dental hygienist or denturist;
(f) A speech-language pathologist or audiologist licensed under ORS chapter 681 or an employee of the speech-language pathologist or audiologist;
(g) An emergency medical technician certified under ORS chapter 682;
(h) An optometrist licensed under ORS chapter 683 or an employee of the optometrist;
(i) A chiropractic physician licensed under ORS chapter 684 or an employee of the chiropractic physician;
(j) A naturopathic physician licensed under ORS chapter 685 or an employee of the naturopathic physician;
(k) A massage therapist licensed under ORS 687.011 to 687.250 or an employee of the massage therapist;
(L) A direct entry midwife licensed under ORS 687.405 to 687.495 or an employee of the direct entry midwife;
(m) A physical therapist licensed under ORS 688.010 to 688.201 or an employee of the physical therapist;
(n) A radiologic technologist licensed under ORS 688.405 to 688.605 or an employee of the radiologic technologist;
(o) A respiratory care practitioner licensed under ORS 688.800 to 688.840 or an employee of the respiratory care practitioner;
(p) A pharmacist licensed under ORS chapter 689 or an employee of the pharmacist;
(q) A dietitian licensed under ORS 691.405 to 691.585 or an employee of the dietitian;
(r) A funeral service practitioner licensed under ORS chapter 692 or an employee of the funeral service practitioner;
(s) A health care facility as defined in ORS 442.015;
(t) A home health agency as defined in ORS 443.005;
(u) A hospice program as defined in ORS 443.850;
(v) A clinical laboratory as defined in ORS 438.010;
(w) A pharmacy as defined in ORS 689.005;
(x) A diabetes self-management program as defined in ORS 743A.184; and
(y) Any other person or entity that furnishes, bills for or is paid for health care in the normal course of business.
(6) “Health information” means any oral or written information in any form or medium that:
(a) Is created or received by a covered entity, a public health authority, an employer, a life insurer, a school, a university or a health care provider that is not a covered entity; and
(b) Relates to:
(A) The past, present or future physical or mental health or condition of an individual;
(B) The provision of health care to an individual; or
(C) The past, present or future payment for the provision of health care to an individual.
(7) “Health insurer” means:
(a) An insurer as defined in ORS 731.106 who offers:
(A) A health benefit plan as defined in ORS 743.730;
(B) A short term health insurance policy, the duration of which does not exceed six months including renewals;
(C) A student health insurance policy;
(D) A Medicare supplemental policy; or
(E) A dental only policy.
(b) The Oregon Medical Insurance Pool operated by the Oregon Medical Insurance Pool Board under ORS 735.600 to 735.650.
(8) “Individually identifiable health information” means any oral or written health information in any form or medium that is:
(a) Created or received by a covered entity, an employer or a health care provider that is not a covered entity; and
(b) Identifiable to an individual, including demographic information that identifies the individual, or for which there is a reasonable basis to believe the information can be used to identify an individual, and that relates to:
(A) The past, present or future physical or mental health or condition of an individual;
(B) The provision of health care to an individual; or
(C) The past, present or future payment for the provision of health care to an individual.
(9) “Payment” includes but is not limited to:
(a) Efforts to obtain premiums or reimbursement;
(b) Determining eligibility or coverage;
(c) Billing activities;
(d) Claims management;
(e) Reviewing health care to determine medical necessity;
(f) Utilization review; and
(g) Disclosures to consumer reporting agencies.
(10) “Personal representative” includes but is not limited to:
(a) A person appointed as a guardian under ORS 125.305, 419B.370, 419C.481 or 419C.555 with authority to make medical and health care decisions;
(b) A person appointed as a health care representative under ORS 127.505 to 127.660 or a representative under ORS 127.700 to 127.737 to make health care decisions or mental health treatment decisions;
(c) A person appointed as a personal representative under ORS chapter 113; and
(d) A person described in ORS 192.526.
(11)(a) “Protected health information” means individually identifiable health information that is maintained or transmitted in any form of electronic or other medium by a covered entity.
(b) “Protected health information” does not mean individually identifiable health information in:
(A) Education records covered by the federal Family Educational Rights and Privacy Act (20 U.S.C. 1232g);
(B) Records described at 20 U.S.C. 1232g(a)(4)(B)(iv); or
(C) Employment records held by a covered entity in its role as employer.
(12) “State health plan” means:
(a) The state Medicaid program;
(b) The Oregon State Children’s Health Insurance Program; or
(c) The Family Health Insurance Assistance Program established in ORS 735.720 to 735.740.
(13) “Treatment” includes but is not limited to:
(a) The provision, coordination or management of health care; and
(b) Consultations and referrals between health care providers. [2003 c.86 §2; 2005 c.253 §1]
Note: See note under 192.518.
Section: Previous 192.501 192.502 192.503 192.505 192.515 192.517 192.518 192.519 192.520 192.521 192.522 192.523 192.524 192.525 192.526 NextLast modified: August 7, 2008