72nd OREGON LEGISLATIVE ASSEMBLY--2003 Regular Session
 
NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .
 
LC 3128
 
                         Senate Bill 848
 
Sponsored by Senator FISHER, Representative WESTLUND
 
 
                             SUMMARY
 
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
 
  Modifies requirements for actuary report for list of health
services developed by Health Services Commission.
 
                        A BILL FOR AN ACT
Relating to administration of Oregon Health Plan; amending ORS
  414.720.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 414.720 is amended to read:
  414.720. (1) The Health Services Commission shall conduct
public hearings prior to making the report described in
subsection (3) of this section. The commission shall solicit
testimony and information from advocates for seniors  { - ;
handicapped persons; - }  { + , persons with disabilities,
 + }mental health services consumers  { - ; - }  { + , + }
low-income Oregonians  { - ; - }  { + , + } and providers of
health care, including but not limited to physicians licensed to
practice medicine, dentists, oral surgeons, chiropractors,
naturopaths, hospitals, clinics, pharmacists, nurses and allied
health professionals.
  (2) The commission shall actively solicit public involvement in
a community meeting process to build a consensus on the values to
be used to guide health resource allocation decisions.
  (3) { + (a) After obtaining the actuary report described in
paragraph (b) of this subsection, + } the commission shall report
to the Governor a list of health services,   { - including health
care services of the aged, blind and disabled pursuant to section
14, chapter 753, Oregon Laws 1991, - }  including one list into
which those mental health and chemical dependency services
recommended pursuant to ORS 414.730 are integrated, ranked by
priority, from the most important to the least important,
representing the comparative benefits of each service to the
entire population to be served.   { - The report shall be
accompanied by a report of an independent actuary retained for
the commission to determine rates necessary to cover the costs of
the services. Until federal waiver approval is obtained and
funding authorized for the integrated list including mental
health and chemical dependency services, the coverage for mental
health and chemical dependency services shall not be considered
to be mandated. - }  The list submitted by the commission
pursuant to this subsection is not subject to alteration by any
other state agency. The recommendation may include practice
guidelines reviewed and adopted by the commission pursuant to
subsection (4) of this section.
   { +  (b) The Secretary of State shall contract with an
independent actuary to determine the average statewide rate to
provide the list of the health services described in paragraph
(a) of this subsection. The actuary shall set the rate using
a __ percentage of the most current Centers for Medicare and
Medicaid Services average adjusted per capita cost Medicare
reimbursement rate for Oregon. The Secretary of State shall
forward the actuary report to the commission when the report is
complete. + }
  (4) In order to encourage effective and efficient medical
evaluation and treatment, the commission may include clinical
practice guidelines in its prioritized list of services. The
commission shall actively solicit testimony and information from
the medical community and the public to build a consensus on
clinical practice guidelines developed by the commission.
  (5) The commission shall make its report by July 1 of the year
preceding each regular session of the Legislative Assembly and
shall submit a copy of its report to the Governor, the Speaker of
the House of Representatives and the President of the Senate.
  (6) The commission may alter the list during interim only under
the following conditions:
  (a) Technical changes due to errors and omissions; and
  (b) Changes due to advancements in medical technology or new
data regarding health outcomes.
  (7) If a service is deleted or added and no new funding is
required, the commission shall report to the Speaker of the House
of Representatives and the President of the Senate. However, if a
service to be added requires increased funding to avoid
discontinuing another service, the commission must report to the
Emergency Board to request the funding.
  (8) The report listing services to be provided pursuant to ORS
414.036, 414.042, 414.065, 414.107, 414.705 to 414.725 and
414.735 to 414.750 shall remain in effect from October 1 of the
odd-numbered year through September 30 of the next odd-numbered
year.
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