76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session
Enrolled
Senate Bill 608
Sponsored by COMMITTEE ON JUDICIARY
CHAPTER ................
AN ACT
Relating to subsidy program for medical professional liability
insurance premiums paid by rural health practitioners;
appropriating money; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + (1) As used in this section:
(a) 'Medical assistance' has the meaning given that term in ORS
414.025.
(b) 'Medicare' means medical coverage provided under Title
XVIII of the Social Security Act.
(c)(A) 'Practitioner' means a physician licensed under ORS
chapter 677 or a nurse practitioner certified under ORS 678.375
who has a rural practice that meets criteria established by the
Office of Rural Health that applied as of January 1, 2004, for
the purposes of ORS 315.613.
(B) 'Practitioner' does not include a physician or nurse
practitioner who is located in an urbanized area of Jackson
County, as defined by the United States Census Bureau according
to the most recent federal decennial census taken pursuant to the
authority of the United States Department of Commerce under 13
U.S.C. 141(a), unless the practitioner is:
(i) A physician who specializes in obstetrics or who
specializes in family or general practice and provides
obstetrical services; or
(ii) A nurse practitioner who is certified for obstetric care.
(2) The Oregon Health Authority shall establish a program to
provide payments to medical professional liability insurance
insurers to subsidize the cost of premiums charged by the
insurers to practitioners described in subsection (3) of this
section.
(3) A practitioner is eligible for a subsidy under this section
if the practitioner:
(a) Holds an active, unrestricted license or certification;
(b) Is covered by a medical professional liability insurance
policy issued by an authorized insurer with minimum limits of
coverage of $1 million per occurrence and $1 million annual
aggregate; and
(c) Except for a nurse practitioner participating in the
program who is employed by a licensed physician, is willing to
serve patients with Medicare coverage and patients receiving
medical assistance in at least the same proportion to the
practitioner's total number of patients as the Medicare and
medical assistance populations represent of the total number of
Enrolled Senate Bill 608 (SB 608-B) Page 1
individuals determined by the Office of Rural Health to be in
need of care in the areas served by the practice.
(4) A practitioner whose medical professional liability
insurance coverage is provided through a health care facility, as
defined in ORS 442.400, and who otherwise meets the requirements
of subsection (3) of this section is eligible for a subsidy if
the office determines that the practitioner:
(a) Is not an employee of the health care facility;
(b) Is covered by a medical professional liability insurance
policy that names the practitioner and separately calculates the
premium for the practitioner; and
(c) Fully reimburses the health care facility for the premium
calculated for the practitioner.
(5) The Oregon Health Authority shall contract with the Office
of Rural Health to establish by rule criteria and procedures for
an annual attestation by participating practitioners of
compliance with the requirements of subsection (3)(c) of this
section. + }
SECTION 2. { + (1)(a) The amount of the subsidy paid by the
Oregon Health Authority under section 1 of this 2011 Act shall be
a percentage of the actual premium charged for medical
professional liability insurance with limits of coverage of $1
million per occurrence and up to $3 million annual aggregate.
However, the premium subsidy for a practitioner referred to in
paragraph (b)(C) or (D) of this subsection shall be the lesser of
the percentage of the premium due or paid for the current
calendar year and the premium paid in the previous calendar year.
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.
(b) The subsidy paid by the Oregon Health Authority under
section 1 of this 2011 Act shall be:
(A) Eighty percent for physicians specializing in obstetrics
and nurse practitioners certified for obstetric care;
(B) Sixty percent for physicians specializing in family or
general practice who provide obstetrical services;
(C) Forty percent for physicians and nurse practitioners
engaging in one or more of the following practices:
(i) Family practice without obstetrical services;
(ii) General practice without obstetrical services;
(iii) Internal medicine;
(iv) Geriatrics;
(v) Pulmonary medicine;
(vi) Pediatrics;
(vii) General surgery; and
(viii) Anesthesiology; and
(D) Fifteen percent for physicians and nurse practitioners
other than those included in subparagraphs (A) to (C) of this
paragraph.
(2) If the funds available for the subsidy program are
insufficient to provide the maximum premium subsidy for all
practitioners who qualify for the program, the authority shall
reduce or eliminate subsidies for practitioners described in
subsection (1)(b)(D) of this section. If, after eliminating
subsidies for practitioners described in subsection (1)(b)(D) of
this section, the funds are insufficient to provide the maximum
premium subsidies for the remaining practitioners, the authority
shall also reduce or eliminate the subsidies for practitioners
described in subsection (1)(b)(C) of this section.
Enrolled Senate Bill 608 (SB 608-B) Page 2
(3) An insurer shall reduce the premium charged to a
practitioner by the amount of any premium subsidy paid or to be
paid under this section and section 1 of this 2011 Act. + }
SECTION 3. { + (1) The Rural Medical Liability Subsidy Fund is
established in the State Treasury separate and distinct from the
General Fund. The Rural Medical Liability Subsidy Fund is
established for the purpose of providing payments under the
subsidy program established under section 1 of this 2011 Act.
Interest earned by the Rural Medical Liability Subsidy Fund shall
be credited to the fund. All moneys in the fund are continuously
appropriated to the Oregon Health Authority.
(2) All moneys received by the Oregon Health Authority for the
purposes of the subsidy program established in section 1 of this
2011 Act shall be deposited to the Rural Medical Liability
Subsidy Fund.
(3) All payments authorized to be made by the authority under
the subsidy program established under section 1 of this 2011 Act
shall be made from the Rural Medical Liability Subsidy Fund. + }
SECTION 4. { + (1) Sections 1 and 2 of this 2011 Act become
operative on January 1, 2012.
(2) The Oregon Health Authority and the Office of Rural Health
may take any actions on or after the effective date of this 2011
Act that are necessary to carry out the provisions of sections 1
and 2 of this 2011 Act on January 1, 2012. + }
SECTION 5. { + The Oregon Health Authority may pay a premium
subsidy under section 1 of this 2011 Act for medical liability
insurance policies issued, in force or renewed on or after
January 1, 2012. + }
SECTION 6. { + On or before January 31 of each odd-numbered
year, the Director of the Oregon Health Authority shall report in
the manner provided by ORS 192.245 to the Legislative Assembly on
the performance of the program established under section 1 of
this 2011 Act. + }
SECTION 7. { + This 2011 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2011 Act takes effect on its
passage. + }
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Passed by Senate June 14, 2011
.............................................................
Robert Taylor, Secretary of Senate
.............................................................
Peter Courtney, President of Senate
Passed by House June 20, 2011
.............................................................
Bruce Hanna, Speaker of House
.............................................................
Arnie Roblan, Speaker of House
Enrolled Senate Bill 608 (SB 608-B) Page 3
Received by Governor:
......M.,............., 2011
Approved:
......M.,............., 2011
.............................................................
John Kitzhaber, Governor
Filed in Office of Secretary of State:
......M.,............., 2011
.............................................................
Kate Brown, Secretary of State
Enrolled Senate Bill 608 (SB 608-B) Page 4