Oregon
LLC
Website link to register:
https://sos.oregon.gov/business
Naming conventions
Cannot include restricted words like “Bank” or “Insurance” without approval. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” Professional practices must include “PLLC.”
Licensing Requirements
Members must hold licenses from the Oregon Medical Board. Malpractice insurance required. Comply with Oregon Health Authority’s facility regulations.
Required documentation for medical practices
Articles of Organization, Outpatient Surgery Facility Permits, Professional Licenses, Malpractice Insurance
Filing Fee: $100
Annual/Biennial Fee: $100
Additional Notes: Annual report due on LLC anniversary date.
Medicaid
Program Name: Oregon Health Plan
Official Website: http://oregon.gov/oha/hsd/ohp
Legislation: Oregon does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Oregon Medicaid, known as the Oregon Health Plan (OHP), provides coverage to eligible low-income residents.
Notification Requirements
Notification strongly recommended to avoid misunderstandings.
Provider Enrollment Requirements
Providers must enroll with OHP to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS guidance supports innovative primary care models in Medicaid.
Opportunities for Collaboration
Opportunities may exist to collaborate with Coordinated Care Organizations (CCOs) or other state initiatives.
State-Specific Notes
Collaboration opportunities exist with Oregon Medicaid Managed Care Organizations for primary care innovation.
Dispensing Medication
Board of Pharmacy Official Link: https://www.oregon.gov/pharmacy
State Licensing
Physicians must register with the Oregon Board of Pharmacy for dispensing controlled substances.
Scope of Practice
Dispensing is allowed for both non-controlled and controlled substances under strict compliance with state laws.
Inventory Management
Accurate inventory management and secure storage are required for all medications.
Record-Keeping
Records must comply with Oregon state laws and federal HIPAA regulations.
Dispensing Standards
Labels must meet Oregon Board of Pharmacy standards, including patient name, prescriber details, and dosage.
Controlled Substances
DEA registration and reporting to Oregon’s PMP are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must adhere to Oregon-specific regulations and federal Stark Law.
Federal Compliance
Physicians must comply with federal FDA, DEA, and OSHA standards for dispensing medications.
State Pharmacy Laws
Physicians must comply with Oregon Board of Pharmacy regulations for dispensing controlled substances.
Patient Consent
Informed consent must be obtained prior to dispensing any medication.
Insurance and Liability
Physicians must ensure their malpractice insurance covers risks associated with dispensing.
Training Requirements
Continuing education is encouraged for compliance with Oregon’s controlled substances regulations.
Audits and Inspections
Inspections by the Oregon Board of Pharmacy ensure compliance, with penalties for violations.