Bill Text: OR HB2020 | 2013 | Regular Session | Engrossed

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

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Bill Title: Relating to standards for health care providers serving members of coordinated care organizations; and declaring an emergency.

Sponsorship: Bipartisan Bill

Status: (Passed) 2013-06-13 - Chapter 362, (2013 Laws): Effective date June 13, 2013. [HB2020 Detail]

Download: Oregon-2013-HB2020-Engrossed.html

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     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 1310

                           B-Engrossed

                         House Bill 2020
                  Ordered by the Senate May 28
 Including House Amendments dated April 17 and Senate Amendments
                          dated May 28

Sponsored by Representative NATHANSON, Senator KNOPP;
  Representatives CONGER, HUFFMAN, Senator SHIELDS

                             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 coordinated care organizations to accept
credentials of mental health treatment providers and chemical
dependency treatment providers found by another coordinated care
organization to meet credentialing requirements. - }
   { +  Requires Oregon Health Authority to convene committee to
advise authority in adopting rules governing authority's on-site
quality assessments of organizations that provide mental health
or chemical dependency treatment. Requires coordinated care
organization to accept assessment conducted by authority as
evidence that provider meets on-site assessment requirements for
credentialing. Provides civil immunity to coordinated care
organization that relies in good faith, for credentialing
purposes, on assessment conducted by authority. Requires
authority to provide report of on-site quality assessment to
insurer or health care service contractor upon request. + }
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to standards for health care providers serving members
  of coordinated care organizations; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + (1) As used in this section:
  (a) 'Assessment' means an on-site quality assessment of an
organizational provider that is conducted:
  (A) If the provider has not been accredited by a national
organization meeting the quality standards of the Oregon Health
Authority;
  (B) By the Oregon Health Authority, another state agency or a
contractor on behalf of the authority or another state agency;
and
  (C) For the purpose of issuing a certificate of approval.
  (b) 'Organizational provider' means an organization that
provides mental health treatment or chemical dependency treatment
and is not a coordinated care organization.
  (2) The Oregon Health Authority shall convene a committee, in
accordance with ORS 183.333, to advise the authority with respect
to the adoption, by rule, of criteria for an assessment. The
advisory committee shall advise the authority during the
development of the criteria. The advisory committee shall be
reconvened as needed to advise the authority with respect to
updating the criteria to conform to changes in national
accreditation standards or federal requirements for health plans
and to advise the authority on opportunities to improve the
assessment process. The advisory committee shall include, but is
not limited to:
  (a) A representative of each coordinated care organization
certified by the authority;
  (b) Representatives of organizational providers;
  (c) Representatives of insurers and health care service
contractors that have been accredited by the National Committee
for Quality Assurance; and
  (d) Representatives of insurers that offer Medicare Advantage
Plans that have been accredited by the National Committee for
Quality Assurance.
  (3) The advisory committee described in subsection (2) of this
section shall recommend:
  (a) Objective criteria for a shared assessment tool that
complies with national accreditation standards and federal
requirements for health plans;
  (b) Procedures for conducting an assessment;
  (c) Procedures to eliminate redundant reporting requirements
for organizational providers; and
  (d) A process for addressing concerns that arise between
assessments regarding compliance with quality standards.
  (4) If another state agency, or a contractor on behalf of the
state agency, conducts an assessment that meets the criteria
adopted by the authority under subsection (2) of this section,
the authority may rely on the assessment as evidence that the
organizational provider meets the assessment requirement for
receiving a certificate of approval.
  (5) The authority shall provide a report of an assessment to
the organizational provider that was assessed and, upon request,
to a coordinated care organization, insurer or health care
service contractor.
  (6) If an organizational provider has not been accredited by a
national organization that is acceptable to a coordinated care
organization, the coordinated care organization shall rely on the
assessment conducted in accordance with the criteria adopted
under subsection (2) of this section as evidence that the
organizational provider meets the assessment requirement.
  (7) This section does not:
  (a) Prohibit a coordinated care organization from requesting
information in addition to the report of the assessment if
necessary to resolve questions about whether an organizational
provider meets the coordinated care organization's policies and
procedures for credentialing;
  (b) Prevent a coordinated care organization from requiring its
own on-site quality assessment if the authority, another state
agency or a contractor on behalf of the authority or another
state agency has not conducted an assessment in the preceding
36-month period; or
  (c) Require a coordinated care organization to contract with an
organizational provider. + }
  SECTION 2. A coordinated care organization, insurer or health
care service contractor that relies in good faith on an
assessment conducted according to the criteria adopted under
section 1 of this 2013 Act shall be immune from civil liability
that might otherwise be incurred or imposed.
  SECTION 3.  { + The Oregon Health Authority must:
  (1) Adopt the criteria described in section 1 of this 2013 Act
no later than January 1, 2014; and

  (2) Report the progress in implementing section 1 of this 2013
Act to the appropriate interim committees of the Legislative
Assembly beginning in September 2013 and at each meeting of the
interim committees until the criteria have been adopted and fully
implemented. + }
  SECTION 4.  { + This 2013 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2013 Act takes effect on its
passage. + }
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