Relating to reinsurance program for medical professional liability insurance policies provided by State Accident Insurance Fund Corporation; amending sections 1, 2, 7, 14 and 15, chapter 781, Oregon Laws 2003; and declaring an emergency.


 
 
 
     74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
 
SA to SB 183
 
LC 577/SB 183-7
 
                      SENATE AMENDMENTS TO
                         SENATE BILL 183
 
            By COMMITTEE ON HEALTH AND HUMAN SERVICES
 
                              May 7
 
  On page 1 of the printed bill, line 3, after '2,' insert ' 6,'.
  In line 10, after '677' insert 'and nurse practitioners
certified by the Oregon State Board of Nursing'.
  Delete lines 12 and 13 and insert 'Rural Health that applied as
of January 1, 2004, for purposes of ORS 315.613, excluding
urbanized areas, as defined by the United States Census Bureau
according to the most recent federal decennial census, pursuant
to the authority of the United States Department of Commerce
under 13 U.S.C. 141;'.
  In line 14, after 'medicine' insert 'or are currently certified
as a nurse practitioner' and delete 'and'.
  In line 16, delete the period and insert '; and
  ' (d) Serve patients with Medicare coverage and patients
receiving medical assistance provided under Medicaid in at least
the same proportion to their total number of patients as the
Medicare and Medicaid populations represent to the total number
of patients in need of care in the rural areas of the counties in
which the doctors practice, as determined by the Office of Rural
Health. The Office of Rural Health shall establish by rule
criteria for and procedures for the annual attestation of
compliance by participating doctors with the requirements of this
paragraph. The requirements of this paragraph do not apply to
nurse practitioners participating in the program.'.
  In line 23, after 'doctors' insert 'and nurse practitioners'.
  On page 2, line 7, delete 'exceed' and insert 'exceeds'.
  After line 9, insert:
  ' (6) As used in this section:
  ' (a) 'Medicaid' means medical assistance provided under 42
U.S.C. 1396a, section 1902 of the Social Security Act.
  ' (b) 'Medicare' means the 'Health Insurance for the Aged Act,'
Title XVIII of the Social Security Amendments of 1965.'.
  In line 29, after 'doctors' insert 'and nurse practitioners'.
  In line 35, delete 'of medicine and doctors of osteopathy ' and
insert 'and nurse practitioners'.
  In line 36, delete 'Up to' and after 'obstetrics' insert ' and
nurse practitioners certified for obstetric care'.
  In line 37, delete 'Up to'.
  In line 38, delete 'and'.
  Delete line 39 and insert:
  ' (C) Up to 40 percent for doctors and nurse practitioners
engaging in one or more of the following practices:
  ' (i) Family practice without obstetrics.
  ' (ii) General practice.
  ' (iii) Internal medicine.
  ' (iv) Geriatrics.
  ' (v) Pulmonary medicine.
  ' (vi) Pediatrics.
  ' (vii) General surgery.
  ' (viii) Anesthesiology; and
 
  ' (D) Up to the following percentages for doctors and nurse
practitioners other than those included in subparagraph (A), (B)
or (C) of this paragraph:
  ' (i) 35 percent, for calendar year 2008.
  ' (ii) 25 percent, for calendar year 2009.
  ' (iii) 15 percent, for calendar year 2010.
  ' (iv) 15 percent, for calendar year 2011.
  ' (b) Notwithstanding section 1 (1)(a), chapter 781, Oregon
Laws 2003, a doctor who meets all the criteria for eligibility
for a reduction in premiums established in section 1 (1)(b), (c)
and (d), chapter 781, Oregon Laws 2003, who has a practice in a
rural area south of Medford, as defined by the Office of Rural
Health as of January 1, 2004, and who specializes in obstetrics,
in family practice and provides obstetrical services, or in
general practice and provides obstetrical services, is entitled
to a reduction in premiums as provided in paragraph (a)(B) of
this subsection.'.
  In line 40, delete '(b)' and insert '(c)'.
  In line 41, after 'for' delete the rest of the line and insert
'lowering or eliminating the amount provided for premium
reductions for the doctors and nurse practitioners eligible for a
reduction in premiums under paragraph (a)(D) of this subsection.
If, after eliminating all premium reductions for the doctors and
nurse practitioners eligible for a reduction in premiums under
paragraph (a)(D) of this subsection, the remaining funds are
insufficient to provide the maximum reductions provided under the
plan, the amounts provided for a reduction in premiums for
doctors and nurse practitioners eligible under paragraph (a)(C)
of this subsection shall be lowered or eliminated.'.
  In line 42, delete '(c)' and insert '(d)'.
  In line 44, after the period insert 'However, the premium
reduction for a doctor or nurse practitioner referred to in
paragraph (a)(C) or (D) of this subsection shall be the lesser of
the percentage of the actual premium or the premium paid by the
doctor or nurse practitioner for calendar year 2007. For a doctor
or nurse practitioner who first becomes eligible for the program
on or after January 1, 2008, the premium reduction shall be the
lesser of the percentage of either the actual premium or the
premium for the first eligibility year determined according to
2007-based rates. When determining the lesser amount under this
paragraph, any step increases in the premium owing to the
claims-made nature of the policy may not be considered.'.
  In line 45, delete '(d) and insert '(e)'.
  On page 3, after line 15, insert:
  ' (5) The plan as modified under subsection (4) of this section
must provide that a doctor or nurse practitioner whose coverage
is provided through a health care facility as defined by ORS
442.400, and who otherwise meets the requirements of section 1
(1), chapter 781, Oregon Laws 2003, is eligible to participate in
the program if the Office of Rural Health determines that the
doctor or nurse practitioner, as of the later of January 1, 2007,
or the date on which the doctor or nurse practitioner first
commences a rural practice:
  ' (a) Is not an employee of the health care facility;
  ' (b) Is covered by a medical professional liability insurance
policy that names the doctor or nurse practitioner and that
separately calculates the premium for the doctor or nurse
practitioner; and
  ' (c) Fully reimburses the health care facility for the premium
calculated for the doctor or nurse practitioner.
  '  { +  SECTION 2a. + } Section 6, chapter 781, Oregon Laws
2003, is amended to read:
  '  { +  Sec. 6. + } (1) If an insurer obtains coverage with the
State Accident Insurance Fund Corporation for medical
professional liability insurance issued by the insurer to a
doctor  { + or nurse practitioner + } to whom section 1 { + ,
chapter 781, Oregon Laws 2003, + }   { - of this 2003 Act - }
applies, the insurer shall reduce the premium charged to the
doctor  { + or nurse practitioner + } in a manner that fully
recognizes savings made available by coverage offered under
section 1 { + , chapter 781, Oregon Laws 2003 + }   { - of this
2003 Act - } .
  ' (2) An insurer to which subsection (1) of this section
applies shall demonstrate the difference in its rates for medical
professional liability insurance for purposes of subsection (1)
of this section in its filing of rates with the Director of the
Department of Consumer and Business Services.'.
  In line 29, delete '2014' and insert '2012'.
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