State and Federal Legislation, OSBHI - Portland Oregon | Oregon Small Business Healthcare Initiative

Oregon 2009 Legislative Session Update

[ read Oregon House Bill HB-2009 ] - PASSED!
Carries the recommendations of the Oregon Health Fund Board, establishing the Oregon Health Authority and the foundation for health system reforms

Establishes Oregon Health Authority Board and Oregon Health Authority and specifies duties, functions and powers. Transfers health functions to authority from Department of Human Services.
Creates Quality Care Institute in Oregon Health Authority.
Directs authority to develop and submit to Legislative Assembly for approval Oregon Health Insurance Exchange plan. Expands eligibility for medical assistance.
Requires authority to implement premium assistance program. Requires Department of Human Services to implement streamlined and simple application process for medical assistance and premium assistance programs.
Requires authority to increase reimbursement rates for health services providers participating in medical assistance program.
Requires authority to conduct outreach for and marketing of medical assistance and premium assistance programs.
Creates tax on health insurance and managed care plans. Sets fixed rate for hospital assessment and removes sunset.
Establishes Oregon Health Authority Fund. Deposits moneys from taxes and assessments into fund. Continuously appropriates moneys in fund to authority for purpose of carrying out functions of authority.

[ read Oregon House Bill HB-2116 ] - PASSED!
Proposes a Provider Tax on 25 DRG hospitals (excludes small rural hospitals) and managed care organizations.

Creates Health System Fund to fund medical assistance and private health options and to pay refunds of hospital assessment.
Modifies hospital assessment. Repeals sunset on hospital assessment. Directs hospital assessment to be paid into Health System Fund.
Creates assessment on insurance premiums to be administered by Department of Consumer and Business Services. Directs assessments minus specified amounts to be paid into Health System Fund.
Creates assessment on capitation payments to Medicaid managed care plans to be administered by Department of Human Services. Directs assessments to be deposited in Health System Fund. Imposes penalties for failure to timely pay assessments.
Establishes Health Care for All Oregon Children program for purpose of providing affordable, accessible health care to all Oregon children. Specifies qualifications for program.
Directs Department of Human Services to provide medical assistance to specified persons for whom a public agency assumed financial responsibility.
Directs Office of Private Health Partnerships to administer private health option for purposes of expanding private health insurance coverage of Oregon’s children.
Directs Department of Human Services to seek federal financial participation for programs relating to health care of Oregon’s children. Specifies other duties of department relating to programs.
Establishes Private Health Option Program Fund. Continuously appropriates moneys in fund to Office of Private Health Partnerships for purposes o administering programs relating to health care of Oregon’s children.

[ read Oregon House Bill HB-3145 ]
Accountability on Health Insurance Rates

Establishes criteria for Department of Consumer and Business Services to use in determination of whether to approve health insurance premium rates. Prescribes information that must be provided by insurer seeking approval of rates.
Requires large employer group health insurers to submit premium rates to Director of Department of Consumer and Business Services for approval.
Creates process for party adversely affected or aggrieved by approval of premium rates to challenge order in contested case and allows award of attorney fees against insurer in favor of prevailing party.

[ read Oregon Senate Bill SB-856 ] - PASSED!
Oregon Senate version of HB 2009

Both HB2009 and SB 856 are the key reform bills this session. Both currently address:
Establishing an authority with directives on actions to be taken, including o Developing a plan for achieving affordable, quality healthcare for all by 2015 o Setting standards for health insurer administrative expenses o Developing uniform contracting standards for purchase of healthcare services by state agencies o Establishing a health insurance exchange
Implementing regulatory actions to control healthcare costs (standards and methods for reviewing and approving insurance premium rates)
Establishment of an all payer, all claims database
Creating an Oregon Quality Institute within the authority
Creating a public employer’s health cooperative
Implementing an integrated healthcare homes model
Establishing a statewide, voluntary POLST registry
Establishing programs for promoting community based innovation
Ensuring Oregon’s healthcare workforce is sufficient
Language prevents health disparities before they occur and improves quality of care
Alignment with federal policy with Oregon’s health reform efforts and
Creating a clinical improvement assessment project.