72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
SA to SB 540
LC 2620/SB 540-6
SENATE AMENDMENTS TO
SENATE BILL 540
By SPECIAL COMMITTEE ON THE OREGON HEALTH PLAN
June 6
In line 2 of the printed bill, after the semicolon insert '
creating new provisions; amending ORS 414.705 and 414.839;
repealing ORS 414.821, 414.823, 414.827, 414.829, 414.833,
414.834, 414.835 and 414.837;'.
Delete lines 4 through 12 and insert:
' { + SECTION 1. + } ORS 414.705 is amended to read:
' 414.705. { + (1) + } As used in ORS 414.705 to 414.750,
'health services' means at least so much of each of the following
as are approved and funded by the Legislative Assembly:
' { - (1) Provider services and supplies; - }
' { - (2) Outpatient services; - }
' { - (3) Inpatient hospital services; and - }
' { - (4) Health promotion and disease prevention
services. - }
' { + (a) Services required by federal law to be included in
the state's medical assistance program in order for the program
to qualify for federal funds;
' (b) Physician services;
' (c) Prescription drugs;
' (d) Laboratory and X-ray services;
' (e) Medical supplies;
' (f) Mental health services;
' (g) Chemical dependency services;
' (h) Dental services;
' (i) Provider services, other than services described in
paragraphs (a) to (h), (j) and (k) of this subsection, defined by
federal law that may be included in the state's medical
assistance program;
' (j) Outpatient hospital services; and
' (k) Inpatient hospital services.
' (2) Health services approved and funded under subsection (1)
of this section are subject to the prioritized list of health
services required in ORS 414.720. + }
' { + SECTION 2. + } { + Sections 3 and 4 of this 2003 Act
are added to and made a part of ORS 414.705 to 414.750. + }
' { + SECTION 3. + } { + The Legislative Assembly shall
approve and fund health services to the following persons in the
following order:
' (1) Persons who are categorically needy as described in ORS
414.025 (2)(n) and (o);
' (2) Persons under 19 years of age and pregnant women with
incomes no more than 200 percent of the federal poverty
guidelines;
' (3) Persons 19 years of age or older with incomes no more
than 50 percent of the federal poverty guidelines;
' (4) Persons 19 years of age or older with incomes above 50
percent of the federal poverty guidelines and no more than 75
percent of the federal poverty guidelines;
' (5) Persons 19 years of age or older with incomes above 75
percent of the federal poverty guidelines and no more than 100
percent of the federal poverty guidelines who do not have federal
Medicare coverage;
' (6) Persons who are medically needy as defined in ORS
414.025; and
' (7) Persons under 19 years of age and pregnant women with
incomes above 200 percent of the federal poverty guidelines and
no more than 225 percent of the federal poverty guidelines. + }
' { + SECTION 4. + } { + (1) Subject to funds available:
' (a) Persons described in section 3 (1), (2) and (7) of this
2003 Act shall receive the health services described in ORS
414.705 (1).
' (b) Persons described in section 3 (6) of this 2003 Act shall
receive the health services described in ORS 414.705 (1)(c), (f),
(g) and (i).
' (c) Persons described in section 3 (3) to (5) of this 2003
Act shall receive the health services described in ORS 414.705
(1)(b) to (k).
' (2) Health services described in ORS 414.705 (1)(a) to (g)
must be provided as a single benefit package for persons
described in section 3 (1), (2) and (7) of this 2003 Act.
' (3) Health services described in ORS 414.705 (1)(b) to (g)
must be provided as a single benefit package for persons
described in section 3 (3) to (5) of this 2003 Act.
' (4) The Department of Human Services shall develop and
prioritize at least three benefit packages of dental services to
be offered under ORS 414.705 (1)(h), including but not limited to
full dental coverage, emergency dental services and emergency
extraction services.
' (5) The department shall develop and prioritize at least
three benefit packages of provider services to be offered under
ORS 414.705 (1)(i).
' (6) The Legislative Assembly shall adjust health services
funded under ORS 414.705 (1):
' (a) By benefit packages in the order of priority listed in
subsection order in subsections (2) to (5) of this section; and
' (b) In the order of priority listed in section 3 of this 2003
Act.
' (7) If insufficient resources are available during a
biennium, the population of eligible persons receiving health
services may not be reduced below the population funded to
receive services on July 1 of the first year of the biennium. + }
' { + SECTION 5. + } { + ORS 414.821, 414.823, 414.827,
414.829, 414.833, 414.834, 414.835 and 414.837 are repealed. + }
' { + SECTION 6. + } { + (1) Except as provided in section 7
of this 2003 Act, sections 3 and 4 of this 2003 Act and the
amendments to ORS 414.705 by section 1 of this 2003 Act become
operative the day after the date the Department of Human Services
is notified by the Centers for Medicare and Medicaid Services
that the request by the department to amend the necessary waivers
has been approved.
' (2) The Director of Human Services shall notify the
Legislative Counsel upon receipt of the approval or disapproval
of the request to amend the necessary waivers. + }
' { + SECTION 7. + } { + The Director of Human Services may
take any action before the operative date of sections 3 and 4 of
this 2003 Act and the amendments to ORS 414.705 by section 1 of
this 2003 Act that is necessary to enable the director to
exercise, on and after the operative date of sections 3 and 4 of
this 2003 Act and the amendments to ORS 414.705 by section 1 this
2003 Act, all the duties, functions and powers conferred on the
director by sections 3 and 4 of this 2003 Act and the amendments
to ORS 414.705 by section 1 of this 2003 Act. + }
' { + SECTION 8. + } { + For the biennium beginning July 1,
2003, the health services provided to persons currently receiving
services under ORS 414.705 to 414.750 shall be the services
provided on June 30, 2003, until sections 3 and 4 of this 2003
Act and the amendments to ORS 414.705 by section 1 of this 2003
Act become operative. + }
' { + SECTION 9. + } ORS 414.839 is amended to read:
' 414.839. { - Subsidies for health insurance coverage. - }
(1) Subject to funds available, the { - waiver program
described by ORS 414.829 shall - } { + Department of Human
Services may + } provide public subsidies for the purchase of
health insurance coverage provided by public programs or private
insurance, including but not limited to the Family Health
Insurance Assistance Program, for currently uninsured individuals
based on incomes up to 185 percent of the federal poverty level.
The objective is to create a transition from dependence on public
programs to privately financed health insurance.
' { - (2) Public subsidies shall apply only to the cost of the
basic benchmark health benefit plan or the approved equivalent
established in ORS 414.829. - }
' { - (3) - } { + (2) + } Cost-sharing shall be permitted
and structured in such a manner to encourage appropriate use of
preventive care and avoidance of unnecessary services.
' { - (4) - } { + (3) + } Cost-sharing shall be based on an
individual's ability to pay and may not exceed the cost of
purchasing a plan
{ - approved as provided under subsection (2) of this
section - } .
' { - (5) - } { + (4) + } The state may pay a portion of the
cost of the subsidy, based on the individual's income and other
resources.
' { + SECTION 10. + } { + This 2003 Act being necessary for
the immediate preservation of the public peace, health and
safety, an emergency is declared to exist, and this 2003 Act
takes effect July 1, 2003. + } ' .
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