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

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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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-Amended.html

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     76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session

SA to SB 210

LC 2672/SB 210-6

                      SENATE AMENDMENTS TO
                         SENATE BILL 210

  By COMMITTEE ON HEALTH CARE, HUMAN SERVICES AND RURAL HEALTH
                             POLICY

                            April 29

  On page 1 of the printed bill, delete lines 5 through 29 and
insert:
  '  { +  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.'.
  On page 2, line 1, delete '2012' and insert '2013'.
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