Bill Text: OR HB2139 | 2013 | Regular Session | Introduced

---

Bill Title: Relating to enrollment in qualified health plans.

Spectrum: Committee Bill

Status: (Failed) 2013-07-08 - In committee upon adjournment. [HB2139 Detail]

Download: Oregon-2013-HB2139-Introduced.html

---

     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 2624

                         House Bill 2139

Introduced and printed pursuant to House Rule 12.00. Presession
  filed (at the request of House Interim Committee on Health
  Care)

                             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.

  Requires Oregon Health Authority to take specified steps to
enroll in qualified health plan person who loses eligibility for
medical assistance.

                        A BILL FOR AN ACT
Relating to enrollment in qualified health plans; creating new
  provisions; and amending ORS 411.085.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Section 2 of this 2013 Act is added to and made
a part of ORS chapter 414. + }
  SECTION 2.  { + (1) If the Oregon Health Authority or the
Department of Human Services receives information that indicates
that a person receiving medical assistance is no longer eligible
for medical assistance, the authority shall determine the
person's eligibility to purchase a qualified health plan through
the Oregon Health Insurance Exchange. The authority may also
determine the person's eligibility for premium tax credits and
reduced cost sharing.
  (2) If the authority determines that the person is eligible to
purchase a qualified health plan through the exchange, the
authority shall notify the person and provide information to the
person about how to select a qualified health plan. The authority
may contract with personal health navigators certified by the
Oregon Health Insurance Exchange Corporation to facilitate the
person's enrollment in a qualified health plan.
  (3) If, by the 10th day following the date on which the notice
described in subsection (2) of this section was sent, the person
does not select a qualified health plan for enrollment, the
authority shall enroll the person in a qualified health plan
that:
  (a) Provides the greatest continuity of care to the person; and
  (b) Most closely resembles the benefits and provider network of
the person's medical assistance program coverage.
  (4) After a person losing medical assistance is enrolled in a
qualified health plan, the authority shall immediately transmit
electronically to the corporation all of the necessary
information.
  (5) If the authority enrolls a person in a qualified health
plan under subsection (3) of this section, the authority shall
notify the person of the person's right to transfer to a
different qualified health plan within 30 days of enrollment or
at the next open enrollment period. + }
  SECTION 3. { +  The Oregon Health Authority shall enter into an
agreement with the Oregon Health Insurance Exchange Corporation
to allow the authority to determine eligibility for qualified
health plans available through the Oregon Health Insurance
Exchange and may enter into an agreement with the corporation to
determine eligibility for premium tax credits and reduced
cost-sharing. + }
  SECTION 4. ORS 411.085 is amended to read:
  411.085. (1) The Department of Human Services  { + and the
Oregon Health Authority + } may reconsider   { - a grant of
general assistance or a grant of - }  { +  a recipient's
eligibility for + } public assistance only for the following
purposes:
  (a) To correct an inadvertent clerical or mathematical error
made when determining   { - a grant of general assistance or a
grant of - }  { +  eligibility for + } public assistance;
  (b) To correct misinformation provided to an applicant or
recipient by the department { +  or the authority + };
  (c) To consider facts not previously known to the department
 { +  or the authority + };
  (d) To correct errors caused by a misapplication of the law by
the department { +  or the authority + };
  (e) To consider substantive changes in the applicable law; or
  (f) To consider a change in circumstances that directly affects
the eligibility of a recipient of   { - general assistance or - }
public assistance.
  (2) A recipient of   { - general assistance or - }  public
assistance may request reconsideration of   { - a grant of
general assistance or a grant of - }  { +  the recipient's
eligibility for + } public assistance for the purposes described
in subsection (1) of this section.
  (3) If the department { + , + }   { - reduces, suspends or
terminates a grant of general assistance or a grant of public
assistance - }  after reconsideration under subsection (1) of
this section,  { + proposes to reduce, suspend or terminate
public assistance, other than medical assistance, + } the
department shall provide an opportunity for a hearing under ORS
chapter 183.  { + If the department or the authority determines
that a recipient is no longer eligible for medical assistance,
the department or the authority shall comply with section 2 of
this 2013 Act. + }
  (4) Notwithstanding subsection (1) of this section, the
department { +  and the authority + } may conduct periodic
redeterminations of eligibility of recipients of   { - grants of
general assistance or grants of - }  public assistance and
participate in audits and other review activities as required by
state or federal law.
  SECTION 5.  { + Section 2 of this 2013 Act and the amendments
to ORS 411.085 by section 4 of this 2013 Act become operative
January 1, 2014. + }
                         ----------