Bill Text: OR SB210 | 2011 | Regular Session | Engrossed

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Bill Title: Relating to the rate of reimbursement for primary care practitioners; declaring an emergency.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2011-06-30 - In committee upon adjournment. [SB210 Detail]

Download: Oregon-2011-SB210-Engrossed.html

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     76th OREGON LEGISLATIVE ASSEMBLY--2011 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 2672

                           A-Engrossed

                         Senate Bill 210
                 Ordered by the Senate April 29
           Including Senate Amendments dated April 29

Sponsored by Senator BATES (Presession filed.)

                             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.

  Requires Oregon Health Authority to reimburse primary care
practitioners directly or through prepaid managed care health
services organizations based on Medicare reimbursement rate.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to the rate of reimbursement for primary care
  practitioners; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Section 2 of this 2011 Act is added to and made
a part of ORS chapter 414. + }
  SECTION 2.  { + (1) As used in this section:
  (a) 'Primary care practitioner' means a nurse practitioner who
is certified by the Oregon State Board of Nursing under ORS
678.375 and who is acting within the scope of practice for a
nurse practitioner, or a physician licensed under ORS chapter 677
whose specialty is family practice, general practice, internal
medicine or pediatrics.
  (b) 'Resource-based relative value scale' means the payment
scale established by the Centers for Medicare and Medicaid
Services under 42 C.F.R. 414.22.
  (2) The Oregon Health Authority shall reimburse primary care
practitioners who are paid for providing health services to
recipients of medical assistance on a fee-for-service basis at a
rate equal to or greater than 150 percent of the resource-based
relative value scale for the practitioners on July 1, 2011.
  (3) Amounts necessary to pay the reimbursements required by
subsection (2) of this section shall be paid out of moneys
available to the Oregon Health Authority for the budget period
during which the reimbursement is to be made.
  (4) The Oregon Health Authority shall calculate the capitation
rate for each prepaid managed care health services organization
as defined in ORS 414.736 using a cost for reimbursing primary
care practitioners providing services through the organization at
the rate established under subsection (2) of this section.
Prepaid managed care health services organizations shall expend
the entire capitation rate payment made pursuant to this

subsection on reimbursing contracted primary care
practitioners. + }
  SECTION 3. Section 2 of this 2011 Act is amended to read:
   { +  Sec. 2. + } (1) As used in this section { + , + }
 { - : - }
    { - (a) - }  'primary care practitioner' means a nurse
practitioner who is certified by the Oregon State Board of
Nursing under ORS 678.375 and who is acting within the scope of
practice for a nurse practitioner, or a physician licensed under
ORS chapter 677 whose specialty is family practice, general
practice, internal medicine or pediatrics.
    { - (b) 'Resource-based relative value scale' means the
payment scale established by the Centers for Medicare and
Medicaid Services under 42 C.F.R. 414.22. - }
  (2) The Oregon Health Authority shall reimburse primary care
practitioners who are paid for providing health services to
recipients of medical assistance on a fee-for-service basis at a
rate equal to or greater than   { - 150 percent of the
resource-based relative value scale - }   { + the rate + } for
the practitioners   { - on July 1, 2011 - }  { +  established
under this section for the previous biennium, multiplied by the
increase in the Portland-Salem Consumer Price Index for All Urban
Consumers for Medical Care as reported by the United States
Bureau of Labor Statistics + }.
  (3) Amounts necessary to pay the reimbursements required by
subsection (2) of this section shall be paid out of moneys
available to the Oregon Health Authority for the budget period
during which the reimbursement is to be made.
  (4) The Oregon Health Authority shall calculate the capitation
rate for each prepaid managed care health services organization
as defined in ORS 414.736 using a cost for reimbursing primary
care practitioners providing services through the organization at
the rate established under subsection (2) of this section.
Prepaid managed care health services organizations shall expend
the entire capitation rate payment made pursuant to this
subsection on reimbursing contracted primary care practitioners.
  SECTION 4.  { + Section 2 of this 2011 Act becomes operative
July 1, 2011. + }
  SECTION 5.  { + The amendments to section 2 of this 2011 Act by
section 3 of this 2011 Act become operative July 1, 2013. + }
  SECTION 6.  { + 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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