Oregon Revised Statutes Chapter 415 § 415.109 — Conduct of examination; access to records; civil penalty

Conduct of examination; access to records; civil penalty. (1) When the Oregon Health Authority determines that an examination should be conducted, the authority shall appoint one or more examiners to perform the examination and instruct them as to the scope of the examination. The authority may prescribe the examiner handbook and employ other guidelines and procedures that the authority determines to be appropriate. (2) The authority may retain appraisers, independent actuaries, independent certified public accountants or other professionals and specialists in conducting an examination, as needed. The coordinated care organization that is the subject of the examination is responsible for the cost of retaining the professionals and specialists. (3) Upon an examination or investigation of a coordinated care organization, the Oregon Health Authority may examine under oath all persons who may have material information regarding the property or business of the coordinated care organization being examined or investigated. (4) Every person being examined or investigated shall produce all books, records, accounts, papers, documents and computer and other recordings in its possession or control relating to the matter under examination or investigation, including, in the case of an examination, the property, assets, business and affairs of the person. (5) With regard to an examination, the officers, directors and agents of the coordinated care organization being examined shall provide timely, convenient and free access at all reasonable hours at the offices of the coordinated care organization being examined to all books, records, accounts, papers, documents and computer and other recordings. The officers, directors, employees and agents of the person must facilitate the examination. (6) In an investigation or examination of a coordinated care organization’s financial condition, the authority may order a coordinated care organization to produce information the coordinated care organization does not possess but to which the coordinated care organization might have access by reason of a contractual relationship or a statutory obligation or by other means. If the coordinated care organization cannot obtain the information the authority requires, the coordinated care organization shall provide the authority with a detailed explanation of the reason the coordinated care organization cannot obtain the information and shall identify the person that possesses the information. If the authority finds that the coordinated care organization’s explanation is without merit, the authority may impose a civil penalty on the coordinated care organization as provided in rules adopted pursuant to ORS 415.011 (2)(g) or may suspend or revoke the coordinated care organization’s contract. [2019 c.478 §9]