75th OREGON LEGISLATIVE ASSEMBLY--2009 Regular Session
Enrolled
Senate Bill 316
Sponsored by Senator DEVLIN, Representative HARKER; Senator
MORRISETTE, Representative CANNON (Presession filed.)
CHAPTER ................
AN ACT
Relating to clinical trials; creating new provisions; and
amending ORS 750.055 and 750.333.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + Section 2 of this 2009 Act is added to and made
a part of ORS chapter 743A. + }
SECTION 2. { + (1) A health benefit plan, as defined in ORS
743.730, shall provide coverage for the routine costs of the care
of patients enrolled in and participating in qualifying clinical
trials.
(2) As used in subsection (1) of this section, 'routine costs':
(a) Means medically necessary conventional care, items or
services covered by the health benefit plan if typically provided
absent a clinical trial.
(b) Does not include:
(A) The drug, device or service being tested in the clinical
trial unless the drug, device or service would be covered for
that indication by the health benefit plan if provided outside of
a clinical trial;
(B) Items or services required solely for the provision of the
drug device
or service being tested in the clinical trial;
(C) Items or services required solely for the clinically
appropriate monitoring of the drug, device or service being
tested in the clinical trial;
(D) Items or services required solely for the prevention,
diagnosis or treatment of complications arising from the
provision of the drug, device or service being tested in the
clinical trial;
(E) Items or services that are provided solely to satisfy data
collection and analysis needs and that are not used in the direct
clinical management of the patient;
(F) Items or services customarily provided by a clinical trial
sponsor free of charge to any participant in the clinical trial;
or
(G) Items or services that are not covered by the health plan
if provided outside of the clinical trial.
(3) As used in subsection (1) of this section, 'qualifying
clinical trial' means a clinical trial that is:
(a) Funded by the National Institutes of Health, the Centers
for Disease Control and Prevention, the Agency for Healthcare
Research and Quality, the Centers for Medicare and Medicaid
Enrolled Senate Bill 316 (SB 316-A) Page 1
Services, the United States Department of Defense or the United
States Department of Veterans Affairs;
(b) Supported by a center or cooperative group that is funded
by the National Institutes of Health, the Centers for Disease
Control and Prevention, the Agency for Healthcare Research and
Quality, the Centers for Medicare and Medicaid Services, the
United States Department of Defense or the United States
Department of Veterans Affairs;
(c) Conducted as an investigational new drug application, an
investigational device exemption or a biologics license
application subject to approval by the United States Food and
Drug Administration; or
(d) Exempt by federal law from the requirement to submit an
investigational new drug application to the United States Food
and Drug Administration.
(4) The coverage required by this section may be subject to
provisions of the health benefit plan that apply to other
benefits within the same category, including but not limited to
copayments, deductibles and coinsurance.
(5) An insurer that provides coverage required by this section
is not, based upon that coverage, liable for any adverse effects
of the clinical trial. + }
SECTION 3. ORS 750.055, as amended by section 5, chapter 22,
Oregon Laws 2008, is amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.664, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184, 743A.188 and 743A.190 { + and section 2 of this 2009
Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
Enrolled Senate Bill 316 (SB 316-A) Page 2
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 4. ORS 750.055, as amended by section 7, chapter 137,
Oregon Laws 2003, section 3, chapter 263, Oregon Laws 2003,
sections 501 and 502, chapter 22, Oregon Laws 2005, sections 5
and 6, chapter 255, Oregon Laws 2005, section 5, chapter 418,
Oregon Laws 2005, section 3, chapter 128, Oregon Laws 2007,
section 9, chapter 182, Oregon Laws 2007, section 6, chapter 313,
Oregon Laws 2007, section 4, chapter 504, Oregon Laws 2007,
section 4, chapter 566, Oregon Laws 2007, section 4, chapter 872,
Oregon Laws 2007, and section 6, chapter 22, Oregon Laws 2008, is
amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.656, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
Enrolled Senate Bill 316 (SB 316-A) Page 3
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184 and 743A.190 { + and section 2 of this 2009 Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 5. ORS 750.333, as amended by section 7, chapter 22,
Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184 { + and section 2 of
this 2009 Act + }.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180, 743A.188 and 743A.190. Multiple employer welfare
arrangements to which ORS 743.730 to 743.773 apply are subject to
Enrolled Senate Bill 316 (SB 316-A) Page 4
the sections referred to in this paragraph only as provided in
ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 6. ORS 750.333, as amended by section 4, chapter 263,
Oregon Laws 2003, section 11, chapter 182, Oregon Laws 2007,
section 8, chapter 313, Oregon Laws 2007, section 6, chapter 504,
Oregon Laws 2007, section 6, chapter 566, Oregon Laws 2007,
section 6, chapter 872, Oregon Laws 2007, and section 8, chapter
22, Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184 { + and section 2 of
this 2009 Act + }.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180 and 743A.190. Multiple employer welfare arrangements to
which ORS 743.730 to 743.773 apply are subject to the sections
referred to in this paragraph only as provided in ORS 743.730 to
743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
Enrolled Senate Bill 316 (SB 316-A) Page 5
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 7. ORS 750.333, as amended by section 8, chapter 137,
Oregon Laws 2003, section 4, chapter 263, Oregon Laws 2003,
section 3, chapter 446, Oregon Laws 2003, section 6, chapter 418,
Oregon Laws 2005, section 12, chapter 182, Oregon Laws 2007,
section 9, chapter 313, Oregon Laws 2007, section 7, chapter 504,
Oregon Laws 2007, section 7, chapter 566, Oregon Laws 2007,
section 7, chapter 872, Oregon Laws 2007, and section 9, chapter
22, Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184 { + and section 2 of
this 2009 Act + }.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.048, 743A.066, 743A.068, 743A.084,
743A.088, 743A.090, 743A.140, 743A.148, 743A.168, 743A.180 and
743A.190. Multiple employer welfare arrangements to which ORS
743.730 to 743.773 apply are subject to the sections referred to
in this paragraph only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 8. { + Section 2 of this 2009 Act and the amendments
to ORS 750.055 and 750.333 by sections 3 to 7 of this 2009 Act
apply to benefits of individuals who enroll or renew an
Enrolled Senate Bill 316 (SB 316-A) Page 6
enrollment in a health benefit plan on or after the effective
date of this 2009 Act. + }
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Passed by Senate April 20, 2009
...........................................................
Secretary of Senate
...........................................................
President of Senate
Passed by House May 28, 2009
...........................................................
Speaker of House
Enrolled Senate Bill 316 (SB 316-A) Page 7
Received by Governor:
......M.,............., 2009
Approved:
......M.,............., 2009
...........................................................
Governor
Filed in Office of Secretary of State:
......M.,............., 2009
...........................................................
Secretary of State
Enrolled Senate Bill 316 (SB 316-A) Page 8