ORS 414.607: Use and disclosure of member information; access by member to personal health information.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) The Oregon Health Authority shall ensure the appropriate use of member information by coordinated care organizations, including the use of electronic health information and administrative data that is available when and where the data is needed to improve health and health care through a secure, confidential health information exchange. (2) A member of a coordinated care organization must have access to the member’s personal health information in the manner provided in 45 C.F.R. 164.524 so the member can share the information with others involved in the member’s care and make better health care and lifestyle choices. (3) Notwithstanding ORS 179.505, a coordinated care organization, its provider network and programs administered by the Department of Human Services for seniors and persons with disabilities shall use and disclose member information for purposes of service and care delivery, coordination, service planning, transitional services and reimbursement, in order to improve the safety and quality of care, lower the cost of care and improve the health and well-being of the organization’s members. (4) A coordinated care organization and its provider network shall use and disclose sensitive diagnosis information including blood-borne infections and other health and mental health diagnoses, within the coordinated care organization for the purpose of providing whole-person care. Individually identifiable health information must be treated as confidential and privileged information subject to ORS 192.553 to 192.581 and applicable federal privacy requirements. Redisclosure of individually identifiable information outside of the coordinated care organization and the organization’s providers for purposes unrelated to this section or the requirements of ORS 413.022, 413.032, 414.572, 414.598, 414.605, 414.632 or 414.655 remains subject to any applicable federal or state privacy requirements. (5) This section does not prohibit the disclosure of information between a coordinated care organization and the organization’s provider network, and the Oregon Health Authority and the Department of Human Services for the purpose of administering the laws of Oregon. (6) The Health Information Technology Oversight Council shall develop readily available informational materials that can be used by coordinated care organizations and providers to inform all participants in the health care workforce about the appropriate uses and limitations on disclosure of electronic health records, including need-based access and privacy mandates. [Formerly 414.679]
Administrative rules citing this section
- OAR 410-141-3505: Use of Subcontractors — implements
- OAR 410-141-3515: Network Adequacy — implements
- OAR 410-141-3525: Outcome and Quality Measures — implements
- OAR 410-141-3570: Managed Care Entity Encounter Claims Data Reporting — implements
- OAR 410-141-3575: MCE Member Relations: Marketing — implements
- OAR 410-141-3700: CCO Application and Contracting Procedures — implements
- OAR 410-141-3730: Community Health Assessment and Community Health Improvement Plans — implements
- OAR 410-141-3735: Social Determinants of Health and Equity; Health Equity — implements
- OAR 410-141-3855: Temporary rule language in effect until 10/27/2026. Pharmaceutical Services — implements
- OAR 410-141-3870: Care Coordination: Service Coordination — implements
- OAR 410-141-3900: Grievances & Appeals: Contested Case Hearings — implements
- OAR 410-141-5000: FINANCIAL SOLVENCY REGULATION: Definitions — implements
- OAR 410-141-5005: FINANCIAL SOLVENCY REGULATION: CCO Financial Solvency Requirements — implements
- OAR 410-141-5010: FINANCIAL SOLVENCY REGULATION: Procedure for General Financial Reporting and for Determining Financial Solvency Matters — implements
- OAR 410-141-5015: FINANCIAL SOLVENCY REGULATION: Financial Statement Reporting — implements
- OAR 410-141-5020: FINANCIAL SOLVENCY REGULATION: Annual Audited Financial Statements and Auditor’s Report — implements
- OAR 410-141-5025: FINANCIAL SOLVENCY REGULATION: Qualifications of Independent Certified Public Accountant — implements
- OAR 410-141-5030: FINANCIAL SOLVENCY REGULATION: Notification of Adverse Financial Condition — implements
- OAR 410-141-5035: FINANCIAL SOLVENCY REGULATION: Accountant's Letter of Qualifications — implements
- OAR 410-141-5040: FINANCIAL SOLVENCY REGULATION: Independent Certified Public Accountants Workpapers — implements
- OAR 410-141-5045: FINANCIAL SOLVENCY REGULATION: Corporate Governance Annual Disclosure Filing — implements
- OAR 410-141-5050: FINANCIAL SOLVENCY REGULATION: Requirements for Reinsurance — implements
- OAR 410-141-5055: FINANCIAL SOLVENCY REGULATION: Requirements for Obtaining Credit for Reinsurance — implements
- OAR 410-141-5060: FINANCIAL SOLVENCY REGULATION: Qualified Trust Agreements — implements
- OAR 410-141-5065: FINANCIAL SOLVENCY REGULATION: Letters of Credit; Other Security — implements
- OAR 410-141-5070: FINANCIAL SOLVENCY REGULATION: Assets, Liabilities, Reserves — implements
- OAR 410-141-5075: FINANCIAL SOLVENCY REGULATION: Disallowance of Certain Reinsurance Transactions — implements
- OAR 410-141-5080: FINANCIAL SOLVENCY REGULATION: Transparency — implements
- OAR 410-141-5085: ASSET VALUATION AND PERMITTED INVESTMENTS: Definitions — implements
- OAR 410-141-5090: ASSET VALUATION AND PERMITTED INVESTMENTS: Calculation of Value; Books and Records — implements
- OAR 410-141-5095: ASSET VALUATION AND PERMITTED INVESTMENTS: Assets Other Than Securities; Bonds; Real Property; Mortgages; Compensating Balances — implements
- OAR 410-141-5100: ASSET VALUATION AND PERMITTED INVESTMENTS: Investments Used to Provide Compensating Balances — implements
- OAR 410-141-5105: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Required Capitalization — implements
- OAR 410-141-5110: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Mortgage Loans — implements
- OAR 410-141-5115: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Real Property — implements
- OAR 410-141-5120: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment in Corporate Stocks — implements
- OAR 410-141-5125: ASSET VALUATION AND PERMITTED INVESTMENTS: Loans; Security; Limitations — implements
- OAR 410-141-5130: ASSET VALUATION AND PERMITTED INVESTMENTS: Investments; Certain Obligations, Property, Loans and Other Specified Items — implements
- OAR 410-141-5135: ASSET VALUATION AND PERMITTED INVESTMENTS: Personal Property; Protection of Investment Property; Custom — implements
- OAR 410-141-5140: ASSET VALUATION AND PERMITTED INVESTMENTS: “Prudent Investor” Standard — implements
- OAR 410-141-5145: ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Conduct by Directors, Trustees, Officers, Agents or Employees — implements
- OAR 410-141-5150: ASSET VALUATION AND PERMITTED INVESTMENTS: Investment of Funds in Obligations That Are Not Investment Quality; Percentage of Assets — implements
- OAR 410-141-5155: ASSET VALUATION AND PERMITTED INVESTMENTS: Approval by Board — implements
- OAR 410-141-5160: ASSET VALUATION AND PERMITTED INVESTMENTS: Record of Investments — implements
- OAR 410-141-5165: ASSET VALUATION AND PERMITTED INVESTMENTS: Prohibited Investments — implements
- OAR 410-141-5170: CAPITALIZATION: Capital and Surplus — implements
- OAR 410-141-5175: CAPITALIZATION: Impaired Capital and Surplus — implements
- OAR 410-141-5180: CAPITALIZATION: Dividend and Distribution Restrictions — implements
- OAR 410-141-5185: CAPITALIZATION: Restricted Reserve Account — implements
- OAR 410-141-5186: CAPITALIZATION: Restricted Reserve Account—Permitted Investments in Obligations with Political Subdivisions; Public Supported Housing — implements
- OAR 410-141-5190: CAPITALIZATION: Surplus Notes — implements
- OAR 410-141-5195: CAPITALIZATION: Risk-based Capital (RBC) Definitions — implements
- OAR 410-141-5200: CAPITALIZATION: RBC Reports — implements
- OAR 410-141-5205: CAPITALIZATION: Company Action Level Event — implements
- OAR 410-141-5210: CAPITALIZATION: Regulatory Action Level Event — implements
- OAR 410-141-5215: CAPITALIZATION: Authorized Control Level Event — implements
- OAR 410-141-5220: CAPITALIZATION: Mandatory Control Level Event — implements
- OAR 410-141-5225: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Extraordinary Dividends and Other Distributions — implements
- OAR 410-141-5230: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Reports of Material Acquisitions And Dispositions Of Assets, and Changes to Ceded Reinsurance Agreements; Assumption Reinsurance — implements
- OAR 410-141-5235: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Reports of Material Materiality and Reporting Standards for Asset Acquisitions and Dispositions — implements
- OAR 410-141-5240: REPORTING AND APPROVAL OF CERTAIN TRANSACTIONS: Materiality and Reporting Standards for Changes in Ceded Reinsurance Agreements — implements
- OAR 410-141-5245: EXAMINATIONS: CCO Production of Books and Records — implements
- OAR 410-141-5250: EXAMINATIONS: Authority Examinations of CCOs — implements
- OAR 410-141-5255: CCO ACQUISITIONS AND MERGERS: Purpose; Definitions — implements
- OAR 410-141-5260: CCO ACQUISITIONS AND MERGERS: Activities Prohibited Unless Certain Provisions Satisfied — implements
- OAR 410-141-5265: CCO ACQUISITIONS AND MERGERS: Procedure For Acquiring Controlling Interest — implements
- OAR 410-141-5270: CCO ACQUISITIONS AND MERGERS: Information to Be Included in Form A — implements
- OAR 410-141-5275: CCO ACQUISITIONS AND MERGERS: Hearing, Request, Notice — implements
- OAR 410-141-5278: CCO ACQUISITIONS AND MERGERS: Confidentiality — implements
- OAR 410-141-5280: CCO ACQUISITIONS AND MERGERS: Determination Concerning Proposed Activity, Time For Decision, Grounds For Refusal — implements
- OAR 410-141-5283: CCO ACQUISITIONS AND MERGERS: Compliance with Conditions — implements
- OAR 410-141-5285: CCO HOLDING COMPANY REGULATION: Definitions — implements
- OAR 410-141-5290: CCO HOLDING COMPANY REGULATION: Members of Holding Company Systems; Registration Requirements — implements
- OAR 410-141-5295: CCO HOLDING COMPANY REGULATION: Form and Contents of Registration Statement — implements
- OAR 410-141-5300: CCO HOLDING COMPANY REGULATION: Registration Statement Filing — implements
- OAR 410-141-5305: CCO HOLDING COMPANY REGULATION: Information Required to Be Disclosed — implements
- OAR 410-141-5310: CCO HOLDING COMPANY REGULATION: Presumption of Control; Rebuttal — implements
- OAR 410-141-5315: CCO HOLDING COMPANY REGULATION: Disclaimer of Affiliation — implements
- OAR 410-141-5318: CCO Holding Company Regulation: Group Capital Calculation — implements
- OAR 410-141-5320: CCO HOLDING COMPANY REGULATION: Transactions Within Holding Company — implements
- OAR 410-141-5323: CCO HOLDING COMPANY REGULATION: Transaction Types Within Holding Company for Disclosure — implements
- OAR 410-141-5325: CCO HOLDING COMPANY REGULATION: Director and Officer Liability; Effect of Control of CCO Subject to Registration; Board of Directors — implements
- OAR 410-141-5330: CCO HOLDING COMPANY REGULATION: Annual Enterprise Risk Report — implements
- OAR 410-141-5335: CCO HOLDING COMPANY REGULATION: Disclaimers and Termination of Registration — implements
- OAR 410-141-5340: CCO HOLDING COMPANY REGULATION: Forms; General Requirements — implements
- OAR 410-141-5345: CCO HOLDING COMPANY REGULATION: Forms; Incorporation by Reference, Summaries, And Omissions — implements
- OAR 410-141-5350: CCO HOLDING COMPANY REGULATION: Forms; Information Unknown or Unavailable and Extension of Time to Furnish — implements
- OAR 410-141-5355: CCO HOLDING COMPANY REGULATION: Forms; Additional Information; Amendments — implements
- OAR 410-141-5360: CCO INSOLVENCY AND DISSOLUTION: Access to Funds and Transition of Members and Records — implements
- OAR 410-141-5365: CCO INSOLVENCY AND DISSOLUTION: Hazardous Operations — implements
- OAR 410-141-5370: CCO INSOLVENCY AND DISSOLUTION: Recovery From Parent Corporation Or Holding Company In The Event Of Liquidation Or Rehabilitation — implements
- OAR 410-141-5375: CCO INSOLVENCY AND DISSOLUTION: Voluntary Dissolution; Approval of Plan — implements
- OAR 410-141-5380: CIVIL PENALTIES — implements
This rule cites
- ORS 179.505 — resolved
- ORS 192.553 — resolved
- 192.581 — resolved
- ORS 413.022 — resolved
- 413.032 — resolved
- 414.572 — resolved
- 414.598 — resolved
- 414.605 — resolved
- 414.632 — resolved
- 414.655 — resolved
Cited by
- ORS 414.619: Coordination between Oregon Health Authority and Department of Human Services.
- ORS 414.654: Persons served by prepaid managed care health services organizations; funding of health information technology.
- ORS 415.055: Confidentiality of complaints; exceptions; publication of annual statistical report of complaints against all CCOs.
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors414.html