74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
 
HA to HB 3501
 
LC 2683/HB 3501-2
 
                       HOUSE AMENDMENTS TO
                         HOUSE BILL 3501
 
                   By COMMITTEE ON HEALTH CARE
 
                             May 10
 
  On page 1 of the printed bill, line 2, after 'hospitals; '
insert 'creating new provisions; and'.
  In line 14, delete '75' and insert '80'.
  In line 15, after 'hospital' insert a period and delete the
rest of the line.
  In line 28, delete '(1)' and insert '(2)'.
  On page 2, after line 1, insert:
  '  { +  SECTION 2. + } ORS 414.743, as amended by section 1 of
this 2007 Act, is amended to read:
  ' 414.743. (1) As used in this section, 'fully capitated health
plan' means an organization that contracts with the Department of
Human Services on a prepaid capitated basis under ORS 414.725 to
provide an adequate network of providers to ensure that all
health services described in ORS 414.705 are reasonably
accessible to enrollees.
  ' (2) A fully capitated health plan that does not have a
contract with a hospital to provide inpatient or outpatient
hospital services under ORS 414.705 to 414.750 must pay for
hospital services   { - at 80 percent of the Medicare rate for
the noncontracting hospital - }  { +  as follows:
  ' (a) For inpatient hospital services, based on the capitation
rates developed for the budget period, at the level of the
statewide average unit cost, multiplied by the geographic factor,
the payment discount factor and an adjustment factor of 0.925.
  ' (b) For outpatient hospital services, based on the capitation
rates developed for the budget period, at the level of charges
multiplied by the statewide average cost-to-charge ratio, the
geographic factor, the payment discount factor and an adjustment
factor of 0.925. + }
  ' (3) A hospital that does not have a contract with a fully
capitated health plan to provide inpatient or outpatient hospital
services under ORS 414.705 to 414.750 must accept   { - as
payment in full the rates described in subsection (2) of this
section - }  { + payment for hospital services as follows:
  ' (a) For inpatient hospital services, based on the capitation
rates developed for the budget period, at the level of the
statewide average unit cost, multiplied by the geographic factor,
the payment discount factor and an adjustment factor of 0.925.
  ' (b) For outpatient hospital services, based on the capitation
rates developed for the budget period, at the level of charges
multiplied by the statewide average cost-to-charge ratio, the
geographic factor, the payment discount factor and an adjustment
factor of 0.925 + }.
  ' (4) This section does not apply to type A and type B
hospitals, as described in ORS 442.470, and rural critical access
hospitals, as defined in ORS 315.613.
  ' (5) The Department of Human Services shall adopt rules to
implement and administer this section.
 
 
  '  { +  SECTION 3. + }  { + The amendments to ORS 414.743 by
section 2 of this 2007 Act become operative on January 2,
2010. + } ' .
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