77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session NOTE: Matter within { + braces and plus signs + } in an amended section is new. Matter within { - braces and minus signs - } is existing law to be omitted. New sections are within { + braces and plus signs + } . LC 2624 House Bill 2139 Introduced and printed pursuant to House Rule 12.00. Presession filed (at the request of House Interim Committee on Health Care) SUMMARY The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject to consideration by the Legislative Assembly. It is an editor's brief statement of the essential features of the measure as introduced. Requires Oregon Health Authority to take specified steps to enroll in qualified health plan person who loses eligibility for medical assistance. A BILL FOR AN ACT Relating to enrollment in qualified health plans; creating new provisions; and amending ORS 411.085. Be It Enacted by the People of the State of Oregon: SECTION 1. { + Section 2 of this 2013 Act is added to and made a part of ORS chapter 414. + } SECTION 2. { + (1) If the Oregon Health Authority or the Department of Human Services receives information that indicates that a person receiving medical assistance is no longer eligible for medical assistance, the authority shall determine the person's eligibility to purchase a qualified health plan through the Oregon Health Insurance Exchange. The authority may also determine the person's eligibility for premium tax credits and reduced cost sharing. (2) If the authority determines that the person is eligible to purchase a qualified health plan through the exchange, the authority shall notify the person and provide information to the person about how to select a qualified health plan. The authority may contract with personal health navigators certified by the Oregon Health Insurance Exchange Corporation to facilitate the person's enrollment in a qualified health plan. (3) If, by the 10th day following the date on which the notice described in subsection (2) of this section was sent, the person does not select a qualified health plan for enrollment, the authority shall enroll the person in a qualified health plan that: (a) Provides the greatest continuity of care to the person; and (b) Most closely resembles the benefits and provider network of the person's medical assistance program coverage. (4) After a person losing medical assistance is enrolled in a qualified health plan, the authority shall immediately transmit electronically to the corporation all of the necessary information. (5) If the authority enrolls a person in a qualified health plan under subsection (3) of this section, the authority shall notify the person of the person's right to transfer to a different qualified health plan within 30 days of enrollment or at the next open enrollment period. + } SECTION 3. { + The Oregon Health Authority shall enter into an agreement with the Oregon Health Insurance Exchange Corporation to allow the authority to determine eligibility for qualified health plans available through the Oregon Health Insurance Exchange and may enter into an agreement with the corporation to determine eligibility for premium tax credits and reduced cost-sharing. + } SECTION 4. ORS 411.085 is amended to read: 411.085. (1) The Department of Human Services { + and the Oregon Health Authority + } may reconsider { - a grant of general assistance or a grant of - } { + a recipient's eligibility for + } public assistance only for the following purposes: (a) To correct an inadvertent clerical or mathematical error made when determining { - a grant of general assistance or a grant of - } { + eligibility for + } public assistance; (b) To correct misinformation provided to an applicant or recipient by the department { + or the authority + }; (c) To consider facts not previously known to the department { + or the authority + }; (d) To correct errors caused by a misapplication of the law by the department { + or the authority + }; (e) To consider substantive changes in the applicable law; or (f) To consider a change in circumstances that directly affects the eligibility of a recipient of { - general assistance or - } public assistance. (2) A recipient of { - general assistance or - } public assistance may request reconsideration of { - a grant of general assistance or a grant of - } { + the recipient's eligibility for + } public assistance for the purposes described in subsection (1) of this section. (3) If the department { + , + } { - reduces, suspends or terminates a grant of general assistance or a grant of public assistance - } after reconsideration under subsection (1) of this section, { + proposes to reduce, suspend or terminate public assistance, other than medical assistance, + } the department shall provide an opportunity for a hearing under ORS chapter 183. { + If the department or the authority determines that a recipient is no longer eligible for medical assistance, the department or the authority shall comply with section 2 of this 2013 Act. + } (4) Notwithstanding subsection (1) of this section, the department { + and the authority + } may conduct periodic redeterminations of eligibility of recipients of { - grants of general assistance or grants of - } public assistance and participate in audits and other review activities as required by state or federal law. SECTION 5. { + Section 2 of this 2013 Act and the amendments to ORS 411.085 by section 4 of this 2013 Act become operative January 1, 2014. + } ----------