74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
HA to A-Eng. HB 2201
LC 717/HB 2201-A40
HOUSE AMENDMENTS TO
A-ENGROSSED HOUSE BILL 2201
By JOINT COMMITTEE ON WAYS AND MEANS
April 20
On page 1 of the printed A-engrossed bill, line 2, after '
414.025,' delete the rest of the line and insert '414.725,
414.839, 442.507, 735.701,'.
On page 2, after line 17, insert:
' (6) Notwithstanding subsection (5) of this section, the
department shall adopt verification requirements to ensure that
recipients of benefits in the Oregon Healthy Kids Program are
legal residents.'.
On page 5, after line 6, insert:
' { + SECTION 4a. + } ORS 414.725 is amended to read:
' 414.725. (1)(a) Pursuant to rules adopted by the Department
of Human Services, the department shall execute prepaid managed
care health services contracts for health services funded by the
Legislative Assembly. The contract must require that all services
are provided to the extent and scope of the Health Services
Commission's report for each service provided under the contract.
The contracts are not subject to ORS chapters 279A and 279B,
except ORS 279A.250 to 279A.290 and 279B.235. Notwithstanding ORS
414.720 (8), the rules adopted by the department shall establish
timelines for executing the contracts described in this
paragraph.
' (b) It is the intent of ORS 414.705 to 414.750 that the state
use, to the greatest extent possible, prepaid managed care health
services organizations to provide physical health, dental, mental
health and chemical dependency services under ORS 414.705 to
414.750.
' (c) The department shall solicit qualified providers or plans
to be reimbursed for providing the covered services. The
contracts may be with hospitals and medical organizations, health
maintenance organizations, managed health care plans and any
other qualified public or private prepaid managed care health
services organization. The department may not discriminate
against any contractors that offer services within their
providers' lawful scopes of practice.
' (2) The department may institute a fee-for-service case
management system or a fee-for-service payment system for the
same physical health, dental, mental health or chemical
dependency services provided under the health services contracts
for persons eligible for health services under ORS 414.705 to
414.750 in designated areas of the state in which a prepaid
managed care health services organization is not able to assign
an enrollee to a person or entity that is primarily responsible
for coordinating the physical health, dental, mental health or
chemical dependency services provided to the enrollee. In
addition, the department may make other special arrangements as
necessary to increase the interest of providers in participation
in the state's managed care system, including but not limited to
the provision of stop-loss insurance for providers wishing to
limit the amount of risk they wish to underwrite.
' (3) As provided in subsections (1) and (2) of this section,
the aggregate expenditures by the department for health services
provided pursuant to ORS 414.705 to 414.750 may not exceed the
total dollars appropriated for health services under ORS 414.705
to 414.750.
' (4) Actions taken by providers, potential providers,
contractors and bidders in specific accordance with ORS 414.705
to 414.750 in forming consortiums or in otherwise entering into
contracts to provide health care services shall be performed
pursuant to state supervision and shall be considered to be
conducted at the direction of this state, shall be considered to
be lawful trade practices and may not be considered to be the
transaction of insurance for purposes of the Insurance Code.
' (5) Health care providers contracting to provide services
under ORS 414.705 to 414.750 shall advise a patient of any
service, treatment or test that is medically necessary but not
covered under the contract if an ordinarily careful practitioner
in the same or similar community would do so under the same or
similar circumstances.
' (6) A prepaid managed care health services organization shall
provide information on contacting available providers to an
enrollee in writing within 30 days of assignment to the health
services organization.
' (7) Each prepaid managed care health services organization
shall provide upon the request of an enrollee or prospective
enrollee annual summaries of the organization's aggregate data
regarding:
' (a) Grievances and appeals; and
' (b) Availability and accessibility of services provided to
enrollees.
' (8) A prepaid managed care health services organization may
not limit enrollment in a designated area based on the zip code
of an enrollee or prospective enrollee.
' { + (9)(a) Notwithstanding subsection (2) of this section,
a prepaid managed care health services organization shall
reimburse a qualified community health center or safety net
clinic for a contracted service provided by the center or clinic
to an enrollee of the organization participating in the Oregon
Healthy Kids Program. The department by rule shall adopt
standards for qualifying community health centers and safety net
clinics for reimbursement under this subsection.
' (b) As used in this subsection, 'community health center or
safety net clinic' means a nonprofit medical clinic that provides
primary physical health, vision, dental or mental health services
to low-income patients without charge or using a sliding fee
scale based on the income of the patient. 'Community health
center or safety net clinic' includes a school-based clinic. + }
' .
Delete lines 9 through 43 and insert:
' { + SECTION 6. + } { + (1) The Office of Private Health
Partnerships shall administer a private health option to expand
private health care coverage for Oregon's children.
' (2) The office shall contract with carriers to provide health
benefit plans approved under section 7 of this 2007 Act. The
office will manage the collection and payment of premiums for
children participating in the plans.
' (3) The office shall provide a subsidy for a health benefit
plan provided pursuant to a contract entered into under this
section for a child whose family's household income is more than
200 percent but no more than 300 percent of the federal poverty
guidelines. The amount of the subsidy shall be determined in
accordance with subsection (4) of this section and is payable to
the carrier in the manner specified by the contract.
' (4) The office shall adopt rules for determining the
subsidies to be paid under this section based upon the following
factors:
' (a) Household income;
' (b) Family size; and
' (c) Other factors established by the office.
' (5) The office shall adopt rules under which families with
household incomes that are more than 300 percent of the federal
poverty guidelines may purchase health benefit plans offered
through the private health option.
' (6) As used in this section and section 7 of this 2007 Act:
' (a) 'Carrier' has the meaning given that term in ORS 735.700.
' (b) 'Child' means a person under 19 years of age.
' (c) 'Health benefit plan' has the meaning given that term in
ORS 735.720. + } ' .
On page 6, line 1, after 'provided' insert 'under section 2
(1)(a) of this 2007 Act and must cover mental health, vision and
dental services.'.
Delete lines 2 through 4.
On page 9, after line 24, insert:
' { + SECTION 17a. + } { + (1) The Healthy Kids Safety Net
Fund is established in the State Treasury, separate and distinct
from the General Fund. Interest earned by the Healthy Kids Safety
Net Fund shall be credited to the fund. The Healthy Kids Safety
Net Fund shall consist of moneys transferred to the fund under
section 20 of this 2007 Act and moneys received by the Department
of Human Services in the form of gifts, grants, bequests,
endowments or donations.
' (2) Moneys in the Healthy Kids Safety Net Fund are
continuously appropriated to the Department of Human Services for
the purpose of carrying out the provisions of section 17b of this
2007 Act. + }
' { + SECTION 17b. + } { + (1) The Department of Human
Services shall award grants to community health centers and
safety net clinics to ensure the capacity of each grantee to
provide health care services to underserved or vulnerable
populations.
' (2) The department shall by rule adopt criteria for awarding
grants under this section.
' (3) As used in this section, 'community health centers and
safety net clinics' means nonprofit medical clinics that provide
primary physical health, vision, dental or mental health services
to low-income patients without charge or using a sliding fee
scale based on the income of the patient. 'Community health
centers and safety net clinics' includes school-based
clinics. + } ' .
Delete lines 38 through 45 and insert:
' { + SECTION 20. + } { + All moneys received by the
Department of Revenue from the tax imposed under section 19 of
this 2007 Act shall be paid over to the State Treasurer to be
held in a suspense account established under ORS 293.445. After
the payment of refunds:
' (1) 6.5 percent shall be transferred to the suspense account
created pursuant to ORS 323.455 (1) and credited in the same
manner as moneys received from the tax imposed by ORS 323.030
(1);
' (2) 13 percent shall be transferred to the suspense account
created pursuant to ORS 323.457 (1) and credited in the same
manner as moneys received from the tax imposed by ORS 323.031
(1);
' (3) 1.097 percent shall be transferred to the Rural Health
Care Revolving Account established by ORS 442.480;
' (4) 2.874 percent shall be transferred to the Healthy Kids
Safety Net Fund established under section 17a of this 2007 Act;
and
' (5) After the amounts described in subsections (1) to (4) of
this section are transferred, the balance of the moneys in the
account shall be credited as follows:
' (a) 5.173 percent shall be credited to the Tobacco Use
Reduction Account established under ORS 431.832 to fund cigarette
and tobacco use prevention and education programs recommended in
the Best Practices for Comprehensive Tobacco Control Programs
published by the United States Department of Health and Human
Services, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion,
Office on Smoking and Health, August 1999; and
' (b) 94.827 percent shall be credited to the Oregon Healthy
Kids Program Fund established by section 12a of this 2007
Act. + }
' { + SECTION 20a. + } Section 20 of this 2007 Act is amended
to read:
' { + Sec. 20. + } All moneys received by the Department of
Revenue from the tax imposed under section 19 of this 2007 Act
shall be paid over to the State Treasurer to be held in a
suspense account established under ORS 293.445. After the payment
of refunds:
' (1) 6.5 percent shall be transferred to the suspense account
created pursuant to ORS 323.455 (1) and credited in the same
manner as moneys received from the tax imposed by ORS 323.030
(1);
' (2) 13 percent shall be transferred to the suspense account
created pursuant to ORS 323.457 (1) and credited in the same
manner as moneys received from the tax imposed by ORS 323.031
(1);
' (3) 1.097 percent shall be transferred to the Rural Health
Care Revolving Account established by ORS 442.480;
' (4) 2.874 percent shall be transferred to the Healthy Kids
Safety Net Fund established under section 17a of this 2007 Act;
and
' (5) After the amounts described in subsections (1) to (4) of
this section are transferred, the balance of the moneys in the
account shall be credited as follows:
' (a) { - 5.173 - } { + 10 + } percent shall be credited to
the Tobacco Use Reduction Account established under ORS 431.832
to fund cigarette and tobacco use prevention and education
programs recommended in the Best Practices for Comprehensive
Tobacco Control Programs published by the United States
Department of Health and Human Services, Centers for Disease
Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Office on Smoking and Health,
August 1999; and
' (b) { - 94.827 - } { + 90 + } percent shall be credited
to the Oregon Healthy Kids Program Fund established by section
12a of this 2007 Act.
' { + SECTION 20b. + } { + Section 20a of this 2007 Act
becomes operative on July 1, 2009. + } ' .
On page 10, delete lines 1 through 11.
On page 13, after line 12, insert:
' { + SECTION 28. + } { + Section 29 of this 2007 Act is
added to and made a part of ORS 442.470 to 442.507. + }
' { + SECTION 29. + } { + The Office of Rural Health may
award to rural health care providers grants that promote any of
the following goals:
' (1) Replacement or renovation of aging rural hospitals.
' (2) Modernization of capital equipment.
' (3) Preservation of access to local health services in rural
areas through short-term support of vulnerable rural health care
providers.
' (4) Expansion of community health educational opportunities.
' (5) Providing incentives for the development of long-term,
sustainable approaches to providing improved health care services
and increased access to quality health care in rural areas.
' (6) Development of collaborative approaches that sustain
access to quality rural health care.
' (7) Expanding or sustaining health care for financially and
physically vulnerable rural populations.
' (8) Providing operational support for rural health centers
that are not federally qualified health centers. + }
' { + SECTION 30. + } ORS 442.507 is amended to read:
' 442.507. (1) { - With the moneys transferred to the Office
of Rural Health by ORS 442.625, - } The Office { + of Rural
Health + } shall establish a dedicated grant program for the
purpose of providing assistance to rural communities to enhance
emergency medical service systems { + , + } { + with moneys
transferred to the office under ORS 442.625 and with 19.7174
percent of the moneys transferred to the Rural Health Care
Revolving Account under section 20 of this 2007 Act + }.
' (2) Communities, as well as nonprofit or governmental
agencies serving those communities, may apply to the office for
grants on forms developed by the office.
' (3) The office shall make the final decision concerning which
entities receive grants, but the office may seek advice from the
Rural Health Coordinating Council, the State Emergency Medical
Service Committee and other appropriate individuals experienced
with emergency medical services.
' (4) The office may make grants to entities for the purchase
of equipment, the establishment of new rural emergency medical
service systems or the improvement of existing rural emergency
medical service systems.
' (5) With the exception of printing and mailing expenses
associated with the grant program, the Office of Rural Health
shall pay for administrative costs of the program with funds
other than those transferred under ORS 442.625.'.
In line 16, delete '28' and insert '31'.
In line 22, delete '29' and insert '32'.
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