Bill Text: OR HB2089 | 2013 | Regular Session | Introduced

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

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Bill Title: Relating to functions of the Oregon Health Authority; and declaring an emergency.

Spectrum: Unknown

Status: (Passed) 2013-03-21 - Chapter 14, (2013 Laws): Effective date March 21, 2013. [HB2089 Detail]

Download: Oregon-2013-HB2089-Introduced.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 346

                         House Bill 2089

Introduced and printed pursuant to House Rule 12.00. Presession
  filed (at the request of Governor John A. Kitzhaber, M.D., for
  Oregon Health Authority)

                             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.

  Authorizes lay representation of Oregon Health Authority and
Department of Human Services at contested case hearings by
representatives from either agency in specified circumstances.
Specifies additional functions of Oregon Health Authority.
Authorizes department to accept small estate affidavits on behalf
of authority. Allows department to operate developmental
disabilities program if county declines to operate program.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to functions of the Oregon Health Authority; creating
  new provisions; amending ORS 114.525, 411.400, 411.402,
  411.404, 414.312, 414.326, 418.748, 430.662 and 676.410 and
  section 20, chapter 595, Oregon Laws 2009; and declaring an
  emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + The Oregon Health Authority and the Department
of Human Services may be represented at contested case hearings
by an officer or employee of either the authority or the
department, subject to the requirements of ORS 183.452. + }
  SECTION 2. ORS 114.525 is amended to read:
  114.525. An affidavit filed under ORS 114.515 shall:
  (1) State the name, age, domicile, post-office address and
Social Security number of the decedent;
  (2) State the date and place of the decedent's death. A
certified copy of the death certificate shall be attached to the
affidavit;
  (3) Describe and state the fair market value of all property in
the estate, including a legal description of any real property;
  (4) State that no application or petition for the appointment
of a personal representative has been granted in Oregon;
  (5) State whether the decedent died testate or intestate, and
if the decedent died testate, the will shall be attached to the
affidavit;
  (6) List the heirs of the decedent and the last address of each
heir as known to the affiant, and state that a copy of the
affidavit showing the date of filing and a copy of the will, if
the decedent died testate, will be delivered to each heir or
mailed to the heir at the last-known address;
  (7) If the decedent died testate, list the devisees of the
decedent and the last address of each devisee as known to the
affiant and state that a copy of the will and a copy of the
affidavit showing the date of filing will be delivered to each
devisee or mailed to the devisee at the last-known address;
  (8) State the interest in the property described in the
affidavit to which each heir or devisee is entitled and the
interest, if any, that will escheat;
  (9) State that reasonable efforts have been made to ascertain
creditors of the estate. List the expenses of and claims against
the estate remaining unpaid or on account of which the affiant or
any other person is entitled to reimbursement from the estate,
including the known or estimated amounts thereof and the names
and addresses of the creditors as known to the affiant, and state
that a copy of the affidavit showing the date of filing will be
delivered to each creditor who has not been paid in full or
mailed to the creditor at the last-known address;
  (10) Separately list the name and address of each person known
to the affiant to assert a claim against the estate that the
affiant disputes and the known or estimated amount thereof and
state that a copy of the affidavit showing the date of filing
will be delivered to each such person or mailed to the person at
the last-known address;
  (11) State that a copy of the affidavit showing the date of
filing will be mailed or delivered to the Department of Human
Services   { - and - }  { +  or to + } the Oregon Health
Authority { + , as prescribed by rule by the authority + };
  (12) State that claims against the estate not listed in the
affidavit or in amounts larger than those listed in the affidavit
may be barred unless:
  (a) A claim is presented to the affiant within four months of
the filing of the affidavit at the address stated in the
affidavit for presentment of claims; or
  (b) A personal representative of the estate is appointed within
the time allowed under ORS 114.555; and
  (13) If the affidavit lists one or more claims that the affiant
disputes, state that any such claim may be barred unless:
  (a) A petition for summary determination is filed within four
months of the filing of the affidavit; or
  (b) A personal representative of the estate is appointed within
the time allowed under ORS 114.555.
  SECTION 3. ORS 411.400 is amended to read:
  411.400. (1) Application for any category of aid shall also
constitute application for medical assistance.
  (2) Except as otherwise provided in this section, a person
shall request medical assistance by filing an application as
provided in ORS 411.081.
  (3) The Department of Human Services  { + and the Oregon Health
Authority + } shall determine eligibility for and fix the date on
which medical assistance may begin, and shall obtain such other
information required by the rules of the department and the
  { - Oregon Health - }  authority under ORS 411.402.
  (4) If an applicant is unable to make application for medical
assistance, an application may be made by someone acting
responsibly for the applicant.
  (5) The department  { + and the authority + } may modify the
application requirements in ORS 411.081 for a person whose basis
of eligibility for medical assistance changes from one category
of aid to another category of aid under ORS 414.025 (2).
  SECTION 4. ORS 411.402 is amended to read:
  411.402. (1) The Department of Human Services and the Oregon
Health Authority shall adopt by rule the documentation required
from each person applying for medical assistance, including
documentation of:
  (a) The identity of the person;

  (b) The category of aid that makes the person eligible for
medical assistance or the way in which the person qualifies as
categorically needy;
  (c) The status of the person as a resident of this state; and
  (d) Information concerning the income and resources of the
person, which may include income tax return information and
Social Security number, as necessary to establish financial
eligibility for medical assistance, premium tax credits and
cost-sharing reductions.
  (2) Information obtained by the department or the authority
under this section may be exchanged with  { + the Oregon Health
Insurance Exchange Corporation and + } other state or federal
agencies for the purpose of:
  (a) Verifying eligibility for medical assistance, participation
in the Oregon Health Insurance Exchange or other health benefit
programs;
  (b) Establishing the amount of any tax credit due to the
person, cost-sharing reduction or premium assistance;
  (c) Improving the provision of services; and
  (d) Administering health benefit programs.
  SECTION 5. ORS 411.404 is amended to read:
  411.404. (1) The Department of Human Services  { + and the
Oregon Health Authority + } shall determine eligibility for
medical assistance according to criteria prescribed by   { - rule
in consultation with the Oregon Health Authority that - }
 { + rules adopted by the department and the authority. The
criteria must + } take into account:
  (a) The requirements and needs of the applicant and of the
spouse and dependents of the applicant;
  (b) The income, resources and maintenance available to the
applicant; and
  (c) The responsibility of the spouse of the applicant and, with
respect to an applicant who is blind or is permanently and
totally disabled or is under 21 years of age, the responsibility
of the parents.
  (2) Rules adopted by the department  { + and the authority + }
under subsection (1) of this section:
  (a) Shall disregard resources for those who are eligible for
medical assistance only by reason of ORS 414.025 (3)(s), except
for the resources described in ORS 414.025 (3)(s).
  (b) May disregard income and resources within the limits
required or permitted by federal law, regulations or orders.
  (c) May not require any needy person over 65 years of age, as a
condition of entering or remaining in a hospital, nursing home or
other congregate care facility, to sell any real property
normally used as the person's home.
    { - (3) Notwithstanding subsections (1) and (2) of this
section, the authority may adopt rules necessary to implement the
Health Care for All Oregon Children program established by ORS
414.231 or applicable provisions of federal law. - }
  SECTION 6. ORS 414.312 is amended to read:
  414.312. (1) As used in ORS 414.312 to 414.318:
  (a) 'Pharmacy benefit manager' means an entity that negotiates
and executes contracts with pharmacies, manages preferred drug
lists, negotiates rebates with prescription drug manufacturers
and serves as an intermediary between the Oregon Prescription
Drug Program, prescription drug manufacturers and pharmacies.
  (b) 'Prescription drug claims processor' means an entity that
processes and pays prescription drug claims, adjudicates pharmacy
claims, transmits prescription drug prices and claims data
between pharmacies and the Oregon Prescription Drug Program and
processes related payments to pharmacies.
  (c) 'Program price' means the reimbursement rates and
prescription drug prices established by the administrator of the
Oregon Prescription Drug Program.

  (2) The Oregon Prescription Drug Program is established in the
Oregon Health Authority. The purpose of the program is to:
  (a) Purchase prescription drugs, replenish prescription drugs
dispensed or reimburse pharmacies for prescription drugs in order
to receive discounted prices and rebates;
  (b) Make prescription drugs available at the lowest possible
cost to participants in the program as a means to promote health;
  (c) Maintain a list of prescription drugs recommended as the
most effective prescription drugs available at the best possible
prices; and
  (d) Promote health through the purchase and provision of
discount prescription drugs and coordination of comprehensive
prescription benefit services for eligible entities and members.
  (3) The Director of the Oregon Health Authority shall appoint
an administrator of the Oregon Prescription Drug Program. The
administrator may:
  (a) Negotiate price discounts and rebates on prescription drugs
with prescription drug manufacturers or group purchasing
organizations;
  (b) Purchase prescription drugs on behalf of individuals and
entities that participate in the program;
  (c) Contract with a prescription drug claims processor to
adjudicate pharmacy claims and transmit program prices to
pharmacies;
  (d) Determine program prices and reimburse or replenish
pharmacies for prescription drugs dispensed or transferred;
  (e) Adopt and implement a preferred drug list for the program;
  (f) Develop a system for allocating and distributing the
operational costs of the program and any rebates obtained to
participants of the program; and
  (g) Cooperate with other states or regional consortia in the
bulk purchase of prescription drugs.
  (4) The following individuals or entities may participate in
the program:
  (a) Public Employees' Benefit Board, Oregon Educators Benefit
Board and Public Employees Retirement System;
  (b) Local governments as defined in ORS 174.116 and special
government bodies as defined in ORS 174.117 that directly or
indirectly purchase prescription drugs;
  (c) Oregon Health and Science University established under ORS
353.020;
  (d) State agencies that directly or indirectly purchase
prescription drugs, including agencies that dispense prescription
drugs directly to persons in state-operated facilities;
  (e) Residents of this state who lack or are underinsured for
prescription drug coverage;
  (f) Private entities; and
  (g) Labor organizations.
  (5) The   { - state agency that receives federal Medicaid funds
and is responsible for implementing the state's medical
assistance program may not participate in the program - }  { +
authority may not purchase prescription drugs directly or
indirectly through the program for recipients of medical
assistance + }.
  (6) The administrator may establish different program prices
for pharmacies in rural areas to maintain statewide access to the
program.
  (7) The administrator may establish the terms and conditions
for a pharmacy to enroll in the program. A licensed pharmacy that
is willing to accept the terms and conditions established by the
administrator may apply to enroll in the program.
  (8) Except as provided in subsection (9) of this section, the
administrator may not:
  (a) Contract with a pharmacy benefit manager;
  (b) Establish a state-managed wholesale or retail drug
distribution or dispensing system; or
  (c) Require pharmacies to maintain or allocate separate
inventories for prescription drugs dispensed through the program.
  (9) The administrator shall contract with one or more entities
to perform any of the functions of the program, including but not
limited to:
  (a) Contracting with a pharmacy benefit manager and directly or
indirectly with such pharmacy networks as the administrator
considers necessary to maintain statewide access to the program.
  (b) Negotiating with prescription drug manufacturers on behalf
of the administrator.
  (10) Notwithstanding subsection (4)(e) of this section,
individuals who are eligible for Medicare Part D prescription
drug coverage may participate in the program.
  (11) The program may contract with vendors as necessary to
utilize discount purchasing programs, including but not limited
to group purchasing organizations established to meet the
criteria of the Nonprofit Institutions Act, 15 U.S.C. 13c, or
that are exempt under the Robinson-Patman Act, 15 U.S.C. 13.
  SECTION 7. ORS 414.326 is amended to read:
  414.326. (1) The   { - Department of Human Services - }  { +
Oregon Health Authority + } shall negotiate and enter into
agreements with pharmaceutical manufacturers for supplemental
rebates that are in addition to the discount required under
federal law to participate in the medical assistance program.
  (2) The   { - department - }  { +  authority + } may
participate in a multistate prescription drug purchasing pool for
the purpose of negotiating supplemental rebates.
  (3) ORS 414.325 and 414.334 apply to prescription drugs
purchased for the medical assistance program under this section.
  SECTION 8. ORS 418.748 is amended to read:
  418.748. (1) The  { + Oregon Health Authority, in collaboration
with the + } Department of Human Services { + , + } shall form a
statewide interdisciplinary team to meet twice a year to review
child fatality cases where child abuse or suicide is suspected,
identify trends, make recommendations and take actions involving
statewide issues.
  (2) The statewide interdisciplinary team may recommend specific
cases to a child fatality review team for its review under ORS
418.785.
  (3) The statewide interdisciplinary team shall provide
recommendations to child fatality review teams in the development
of protocols. The recommendations shall address investigation,
training, case selection and fatality review of child deaths,
including but not limited to child abuse and youth suicide cases.
  SECTION 9. ORS 430.662 is amended to read:
  430.662. (1) The Department of Human Services, in carrying out
the legislative policy declared in ORS 430.610, subject to the
availability of funds, shall:
  (a) Assist Oregon counties and groups of Oregon counties in the
establishment and financing of community developmental
disabilities programs operated or contracted for by one or more
counties.
  (b) If a county declines to operate or contract for a community
developmental disabilities program  { - , - }  { +  or to provide
developmental disabilities services required by ORS 430.630:
  (A) + } Contract with another public agency or private
  { - corporation to provide - }  { +  entity to operate + } the
program  { - . - }  { +  or provide the services  + }  { - the
county must be provided with an opportunity to review and
comment. - }  { + ; or
  (B) Operate the program and provide the services. + }
    { - (c) In an emergency situation when no community
developmental disabilities program is operating within a county,
operate the program or service on a temporary basis. - }
    { - (d) - }  { +  (c) + } At the request of the tribal
council of a federally recognized tribe of Native Americans,
contract with the tribal council for the establishment and
operation of a community developmental disabilities program in
the same manner in which the department contracts with a county
court or board of county commissioners.
    { - (e) - }  { +  (d) + } If a county agrees, contract with a
public agency or private corporation for all developmental
disabilities services.
    { - (f) - }  { +  (e) + } Approve or disapprove the biennial
plan and budget information for the establishment and operation
of each community developmental disabilities program. Subsequent
amendments to or modifications of an approved plan or budget
information involving more than 10 percent of the state funds
provided for services under ORS 430.664 may not be placed in
effect without prior approval of the department. However, an
amendment or modification affecting 10 percent or less of state
funds for services under ORS 430.664 within the portion of the
program for persons with developmental disabilities may be made
without department approval.
    { - (g) - }  { +  (f) + } Make all necessary and proper rules
to govern the establishment and operation of community
developmental disabilities programs.
  (2) The enumeration of duties and functions in subsection (1)
of this section may not be deemed exclusive or construed as a
limitation on the powers and authority vested in the department
by other provisions of law.
  SECTION 10. ORS 676.410 is amended to read:
  676.410. (1) As used in this section, 'healthcare workforce
regulatory board' means the:
  (a) Occupational Therapy Licensing Board;
  (b) Oregon Medical Board;
  (c) Oregon State Board of Nursing;
  (d) Oregon Board of Dentistry;
  (e) Physical Therapist Licensing Board;
  (f) State Board of Pharmacy; and
  (g)   { - Board of Licensed Dietitians - }  { +  Oregon Health
Licensing Agency for dietitians licensed under ORS 691.435 + }.
  (2)(a) An applicant for a license from a healthcare workforce
regulatory board or renewal of a license by a healthcare
workforce regulatory board shall provide the information
prescribed by the Office for Oregon Health Policy and Research
pursuant to subsection (3) of this section.
  (b) Except as provided in subsection (4) of this section, a
healthcare workforce regulatory board may not approve a
subsequent application for a license or renewal of a license
until the applicant provides the information.
  (3) The Administrator for the Office for Oregon Health Policy
and Research shall collaborate with the healthcare workforce
regulatory boards to adopt rules for the manner, form and content
for reporting, and the information that must be provided to a
healthcare workforce regulatory board under subsection (2) of
this section, which may include:
  (a) Demographics, including race and ethnicity.
  (b) Education information.
  (c) License information.
  (d) Employment information.
  (e) Primary and secondary practice information.
  (f) Anticipated changes in the practice.
  (g) Languages spoken.
  (4)(a) A healthcare workforce regulatory board shall report
healthcare workforce information collected under subsection (2)
of this section to the Office for Oregon Health Policy and
Research.
  (b) A healthcare workforce regulatory board shall keep
confidential and not release personally identifiable data
collected under this section for a person licensed, registered or
certified by a board. This paragraph does not apply to the
release of information to a law enforcement agency for
investigative purposes or to the release to the Office for Oregon
Health Policy and Research for state health planning purposes.
  (5) The requirements of subsection (2) of this section apply to
an applicant for issuance or renewal of a license who is or who
is applying to become:
  (a) An occupational therapist or certified occupational therapy
assistant as defined in ORS 675.210;
  (b) A physician as defined in ORS 677.010;
  (c) A physician assistant as defined in ORS 677.495;
  (d) A nurse or nursing assistant licensed or certified under
ORS 678.010 to 678.410;
  (e) A dentist or dental hygienist as defined in ORS 679.010;
  (f) A physical therapist or physical therapist assistant as
defined in ORS 688.010;
  (g) A pharmacist or pharmacy technician as defined in ORS
689.005; or
  (h) A licensed dietitian, as defined in ORS 691.405.
  (6) A healthcare workforce regulatory board may adopt rules as
necessary to perform the board's duties under this section.
  (7) In addition to licensing fees that may be imposed by a
healthcare workforce regulatory board, the Oregon Health Policy
Board shall establish fees to be paid by applicants for issuance
or renewal of licenses reasonably calculated to reimburse the
actual cost of obtaining or reporting information as required by
subsection (2) of this section.
  SECTION 11. Section 20, chapter 595, Oregon Laws 2009, as
amended by section 224, chapter 720, Oregon Laws 2011, is amended
to read:
   { +  Sec. 20. + }   { - On or before January 2, 2014, the
Department - }   { + The + }  { +  Director  + }of Human Services
and the  { + Director of the + } Oregon Health Authority may
delegate to each other  { + by interagency agreement  + }any
duties, functions or powers   { - transferred by section 19,
chapter 595, Oregon Laws 2009, that the department or the
authority deems - }  { + granted to the department or the
authority by law, as the directors deem  + }necessary for the
efficient and effective operation of their  { + agencies' + }
respective functions.
  SECTION 12.  { + 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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