Bill Text: OR SB216 | 2011 | Regular Session | Engrossed

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Bill Title: Relating to medical assistance; declaring an emergency.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2011-06-30 - In committee upon adjournment. [SB216 Detail]

Download: Oregon-2011-SB216-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 2671

                           A-Engrossed

                         Senate Bill 216
                 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 increase capitation
rates paid to prepaid managed care health services organizations
if changes in medical assistance benefits increase overall cost
to organizations by one percent or more. - }
   { +  Prohibits Oregon Health Authority from taking actions
that cumulatively increase cost to prepaid managed care health
services organization of providing health services during one
biennium by more than one percent without prior approval of Joint
Committee on Ways and Means.
  Declares emergency, effective on passage. + }

                        A BILL FOR AN ACT
Relating to medical assistance; 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) Without prior approval by the Joint
Committee on Ways and Means, the Oregon Health Authority may not
take any action or series of actions described in subsection (2)
of this section that cumulatively increase the cost to a prepaid
managed care health services organization of providing health
services during a biennium by more than one percent.
  (2) As used in this section, 'action' includes:
  (a) The amendment or adoption of an administrative rule;
  (b) An amendment to a contract between the authority and a
prepaid managed care health services organization;
  (c) A change in administrative requirements; or
  (d) A policy change that results in adding coverage for a group
of enrollees with high health care costs generally, or in
removing from coverage a group of enrollees with low health care
costs generally.
  (3) The authority shall calculate the cumulative increase in
the cost to a prepaid managed care health services organization
of providing health services using an actuarially sound method.
The authority shall make the calculation publicly available. + }
  SECTION 3.  { + Section 2 of this 2011 Act applies to any
actions by the Oregon Health Authority taken during the term of
contracts executed with prepaid managed care health services
organizations for the 2011 calendar year and subsequent calendar
years. The authority shall seek retroactive approval by the Joint
Committee on Ways and Means for any actions taken during the 2011
contract year that increased the cost to prepaid managed care
health services organizations of providing health services by
more than one percent. + }
  SECTION 4.  { + 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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