Bill Text: OR HB3409 | 2011 | Regular Session | Introduced
Bill Title: Relating to health care; declaring an emergency.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2011-06-30 - In committee upon adjournment. [HB3409 Detail]
Download: Oregon-2011-HB3409-Introduced.html
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 3202
House Bill 3409
Sponsored by Representative KOTEK
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 payment for dental services under Family Health
Insurance Assistance Program and under private health option of
Health Care for All Oregon Children program. Authorizes Oregon
Health Authority to provide packages of health services to
specified groups of medical assistance recipients that are less
comprehensive than health services on prioritized list of health
services approved and funded by Legislative Assembly.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to health care; creating new provisions; amending ORS
414.025, 414.065, 414.428, 414.705, 414.706, 414.708, 414.709,
414.712, 414.720, 414.725, 414.735, 414.737, 414.738, 414.739,
414.740, 414.741, 414.826, 414.841, 414.842, 414.844 and
735.625; repealing ORS 414.707; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 414.826 is amended to read:
414.826. (1) As used in this section:
(a) 'Child' means a person under 19 years of age who is
lawfully present in this state.
{ + (b) 'Dental plan' has the meaning given that term in ORS
414.841. + }
{ - (b) - } { + (c) + } 'Health benefit plan' has the
meaning given that term in ORS 414.841.
(2) The Office of Private Health Partnerships shall administer
a private health option to expand access to private health
insurance for Oregon's children.
(3) The office shall adopt by rule criteria for health benefit
plans to qualify for premium assistance under the private health
option. The criteria may include, but are not limited to, the
following:
(a) The health benefit plan meets or exceeds the requirements
for a basic benchmark health benefit plan under ORS 414.856.
(b) The health benefit plan offers a benefit package comparable
to the health services provided to children receiving medical
assistance, including mental health, vision and dental services,
and without any exclusion of or delay of coverage for preexisting
conditions.
(c) The health benefit plan imposes copayments or other cost
sharing that is based upon a family's ability to pay.
(d) Expenditures for the health benefit plan qualify for
federal financial participation.
{ + (4) To qualify for premium assistance under the private
health option:
(a) A dental plan must provide coverage of dental services
necessary to prevent disease and promote oral health, restore
oral structures to health and function and treat emergency
conditions.
(b) Expenditures for the dental plan must qualify for federal
financial participation. + }
{ - (4) - } { + (5) + } The amount of premium assistance
provided under this section shall be:
(a) Equal to the full cost of the { - premium - } { +
premiums for a health benefit plan and a dental plan + } for
children whose family income is at or below 200 percent of the
federal poverty guidelines and who have access to employer
sponsored health insurance; and
(b) Based on a sliding scale under criteria established by the
office by rule for children whose family income is above 200
percent but at or below 300 percent of the federal poverty
guidelines, regardless of whether the child has access to
coverage under an employer sponsored health benefit plan { + or
dental plan + }.
{ - (5) - } { + (6) + } A child whose family income is more
than 300 percent of the federal poverty guidelines shall be
offered the opportunity to purchase a health benefit plan { + or
dental plan + } through the private health option but may not
receive premium assistance.
SECTION 2. ORS 414.841 is amended to read:
414.841. For purposes of ORS 414.841 to 414.864:
(1) 'Carrier' has the meaning given that term in ORS 735.700.
{ + (2) 'Dental plan' means a policy or certificate of group
or individual health insurance, as defined in ORS 731.162,
providing payment or reimbursement only for the expenses of
dental care. + }
{ - (2) - } { + (3) + } 'Eligible individual' means an
individual who:
(a) Is a resident of the State of Oregon;
(b) Is not eligible for Medicare;
(c) { + Is + } either { + :
(A) For health benefit plan coverage other than dental plans, a
person who + } has been without health benefit plan coverage for
a period of time established by the Office of Private Health
Partnerships { - , - } or meets exception criteria established
by the office; { + or
(B) For dental plan coverage, an individual under 19 years of
age who is uninsured or underinsured with respect to dental plan
coverage; + }
(d) Except as otherwise provided by the office, has family
income { - less than - } { + at or below + } 200 percent of
the federal poverty level; { + and + }
{ - (e) Has investments and savings less than the limit
established by the office; and - }
{ - (f) - } { + (e) + } Meets other eligibility criteria
established by the office.
{ - (3)(a) - } { + (4)(a) + } 'Family' means:
(A) A single individual;
(B) An adult and the adult's spouse;
(C) An adult and the adult's spouse, all unmarried, dependent
children under 23 years of age, including adopted children,
children placed for adoption and children under the legal
guardianship of the adult or the adult's spouse, and all
dependent children of a dependent child; or
(D) An adult and the adult's unmarried, dependent children
under 23 years of age, including adopted children, children
placed for adoption and children under the legal guardianship of
the adult, and all dependent children of a dependent child.
(b) A family includes a dependent elderly relative or a
dependent adult child with a disability who meets the criteria
established by the office and who lives in the home of the adult
described in paragraph (a) of this subsection.
{ - (4)(a) - } { + (5)(a) + } 'Health benefit plan' means a
policy or certificate of group or individual health insurance, as
defined in ORS 731.162, providing payment or reimbursement for
hospital, medical and surgical expenses. 'Health benefit plan'
includes a health care service contractor or health maintenance
organization subscriber contract, the Oregon Medical Insurance
Pool and any plan provided by a less than fully insured multiple
employer welfare arrangement or by another benefit arrangement
defined in the federal Employee Retirement Income Security Act of
1974, as amended.
(b) 'Health benefit plan' does not include coverage for
accident only, specific disease or condition only, credit,
disability income, coverage of Medicare services pursuant to
contracts with the federal government, Medicare supplement
insurance, student accident and health insurance, long term care
insurance, hospital indemnity only, { - dental only, - }
vision only, coverage issued as a supplement to liability
insurance, insurance arising out of a workers' compensation or
similar law, automobile medical payment insurance, insurance
under which the benefits are payable with or without regard to
fault and that is legally required to be contained in any
liability insurance policy or equivalent self-insurance or
coverage obtained or provided in another state but not available
in Oregon.
{ - (5) - } { + (6) + } 'Income' means gross income in cash
or kind available to the applicant or the applicant's family.
Income does not include earned income of the applicant's children
or income earned by a spouse if there is a legal separation.
{ - (6) 'Investment and savings' means cash, securities as
defined in ORS 59.015, negotiable instruments as defined in ORS
73.0104 and such similar investments or savings as the office may
establish that are available to the applicant or the applicant's
family to contribute toward meeting the needs of an applicant or
eligible individual. - }
(7) 'Medicaid' means medical assistance provided under 42
U.S.C. section 1396a (section 1902 of the Social Security Act).
(8) 'Resident' means an individual who meets the residency
requirements established by rule by the office.
(9) 'Subsidy' means payment or reimbursement to an eligible
individual toward the purchase of a health benefit plan, and may
include a net billing arrangement with carriers or a prospective
or retrospective payment for health benefit plan premiums and
eligible copayments or deductible expenses directly related to
the eligible individual.
(10) 'Third-party administrator' means any insurance company or
other entity licensed under the Insurance Code to administer
health { - insurance - } benefit { - programs - } { +
plans + }.
SECTION 3. ORS 414.844 is amended to read:
414.844. (1) To enroll in the Family Health Insurance
Assistance Program established in ORS 414.841 to 414.864, an
applicant shall submit a written application to the Office of
Private Health Partnerships or to the third-party administrator
contracted by the office to administer the program pursuant to
ORS 414.842 in the form and manner prescribed by the office.
Except as provided in ORS 414.848, if the applicant qualifies as
an eligible individual, the applicant shall either be enrolled in
the program or placed on a waiting list for enrollment.
(2) After an eligible individual has enrolled in the program,
the individual shall remain eligible for enrollment for the
period of time established by the office.
(3) After an eligible individual has enrolled in the program,
the office or third-party administrator shall issue subsidies in
an amount determined pursuant to ORS 414.846 to either the
eligible individual or to the carrier designated by the eligible
individual, subject to the following restrictions:
(a) Subsidies may not be issued to an eligible individual
unless all eligible children, if any, in the eligible
individual's family are covered under a health benefit plan or
Medicaid.
(b) Subsidies may not be used to subsidize premiums on a health
benefit plan whose premiums are wholly paid by the eligible
individual's employer without contribution from the employee.
(c) Such other restrictions as the office may adopt.
(4) The office may issue subsidies to an eligible individual in
advance of a purchase of a health benefit plan.
(5) To remain eligible for a subsidy, an eligible individual
must enroll in a group health benefit plan if a plan is available
to the eligible individual through the individual's employment
and the employer makes a monetary contribution toward the cost of
the plan, unless the office implements specific cost or benefit
structure criteria that make enrollment in an individual health
insurance plan more advantageous for the eligible individual.
{ - (6) Notwithstanding ORS 414.841 (4)(b), if an eligible
individual is enrolled in a group health benefit plan available
to the eligible individual through the individual's employment
and the employer requires enrollment in both a health benefit
plan and a dental plan, the individual is eligible for a subsidy
for both the health benefit plan and the dental plan. - }
SECTION 4. ORS 414.025, as amended by section 1, chapter 73,
Oregon Laws 2010, is amended to read:
414.025. As used in this chapter, unless the context or a
specially applicable statutory definition requires otherwise:
(1) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, aid granted under ORS 412.001 to
412.069 and 418.647 or federal Supplemental Security Income
payments.
(2) 'Categorically needy' means, insofar as funds are available
for the category, a person who is a resident of this state and
who:
(a) Is receiving a category of aid.
(b) Would be eligible for a category of aid but is not
receiving a category of aid.
(c) Is in a medical facility and, if the person left such
facility, would be eligible for a category of aid.
(d) Is under the age of 21 years and would be a dependent child
as defined in ORS 412.001 except for age and regular attendance
in school or in a course of professional or technical training.
(e)(A) Is a caretaker relative, as defined in ORS 412.001, who
cares for a child who would be a dependent child except for age
and regular attendance in school or in a course of professional
or technical training; or
(B) Is the spouse of the caretaker relative.
(f) Is under the age of 21 years and:
(A) Is in a foster family home or licensed child-caring agency
or institution and is one for whom a public agency of this state
is assuming financial responsibility, in whole or in part; or
(B) Is 18 years of age or older, is one for whom federal
financial participation is available under Title XIX or XXI of
the federal Social Security Act and who met the criteria in
subparagraph (A) of this paragraph immediately prior to the
person's 18th birthday.
(g) Is a spouse of an individual receiving a category of aid
and who is living with the recipient of a category of aid, whose
needs and income are taken into account in determining the cash
needs of the recipient of a category of aid, and who is
determined by the Department of Human Services to be essential to
the well-being of the recipient of a category of aid.
(h) Is a caretaker relative as defined in ORS 412.001 who cares
for a dependent child receiving aid granted under ORS 412.001 to
412.069 and 418.647 or is the spouse of the caretaker relative.
(i) Is under the age of 21 years, is in a youth care center and
is one for whom a public agency of this state is assuming
financial responsibility, in whole or in part.
(j) Is under the age of 21 years and is in an intermediate care
facility which includes institutions for persons with mental
retardation.
(k) Is under the age of 22 years and is in a psychiatric
hospital.
(L) Is under the age of 21 years and is in an independent
living situation with all or part of the maintenance cost paid by
the Department of Human Services.
(m) Is a member of a family that received aid in the preceding
month under ORS 412.006 or 412.014 and became ineligible for aid
due to increased hours of or increased income from employment. As
long as the member of the family is employed, such families will
continue to be eligible for medical assistance for a period of at
least six calendar months beginning with the month in which such
family became ineligible for assistance due to increased hours of
employment or increased earnings.
(n) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part.
(o) Is an individual or is a member of a group who is required
by federal law to be included in the state's medical assistance
program in order for that program to qualify for federal funds.
(p) Is an individual or member of a group who, subject to the
rules of the department, may optionally be included in the
state's medical assistance program under federal law and
regulations concerning the availability of federal funds for the
expenses of that individual or group.
(q) Is a pregnant woman who would be eligible for aid granted
under ORS 412.001 to 412.069 and 418.647, whether or not the
woman is eligible for cash assistance.
(r) Except as otherwise provided in this section, is a pregnant
woman or child for whom federal financial participation is
available under Title XIX or XXI of the federal Social Security
Act.
(s) Is not otherwise categorically needy and is not eligible
for care under Title XVIII of the federal Social Security Act or
is not a full-time student in a post-secondary education program
as defined by the Department of Human Services by rule, but whose
family income is { - less than - } { + at or below + } the
federal poverty level and whose family investments and savings
equal less than the investments and savings limit established by
the department by rule.
(t) Would be eligible for a category of aid but for the receipt
of qualified long term care insurance benefits under a policy or
certificate issued on or after January 1, 2008. As used in this
paragraph, 'qualified long term care insurance' means a policy or
certificate of insurance as defined in ORS 743.652 (6).
(u) Is eligible for the Health Care for All Oregon Children
program established in ORS 414.231.
(3) 'Income' has the meaning given that term in ORS 411.704.
(4) 'Investments and savings' means cash, securities as defined
in ORS 59.015, negotiable instruments as defined in ORS 73.0104
and such similar investments or savings as the Department of
Human Services may establish by rule that are available to the
applicant or recipient to contribute toward meeting the needs of
the applicant or recipient.
(5) 'Medical assistance' means so much of the following medical
and remedial care and services as may be prescribed by the Oregon
Health Authority according to the standards established pursuant
to ORS { - 413.032 - } { + 414.065 + }, including
{ + premium assistance and + } payments made for services
provided under an insurance or other contractual arrangement and
money paid directly to the recipient for the purchase of medical
care:
(a) Inpatient hospital services, other than services in an
institution for mental diseases;
(b) Outpatient hospital services;
(c) Other laboratory and X-ray services;
(d) Skilled nursing facility services, other than services in
an institution for mental diseases;
(e) Physicians' services, whether furnished in the office, the
patient's home, a hospital, a skilled nursing facility or
elsewhere;
(f) Medical care, or any other type of remedial care recognized
under state law, furnished by licensed practitioners within the
scope of their practice as defined by state law;
(g) Home health care services;
(h) Private duty nursing services;
(i) Clinic services;
(j) Dental services;
(k) Physical therapy and related services;
(L) Prescribed drugs, including those dispensed and
administered as provided under ORS chapter 689;
(m) Dentures and prosthetic devices; and eyeglasses prescribed
by a physician skilled in diseases of the eye or by an
optometrist, whichever the individual may select;
(n) Other diagnostic, screening, preventive and rehabilitative
services;
(o) Inpatient hospital services, skilled nursing facility
services and intermediate care facility services for individuals
65 years of age or over in an institution for mental diseases;
(p) Any other medical care, and any other type of remedial care
recognized under state law;
(q) Periodic screening and diagnosis of individuals under the
age of 21 years to ascertain their physical or mental
impairments, and such health care, treatment and other measures
to correct or ameliorate impairments and chronic conditions
discovered thereby;
(r) Inpatient hospital services for individuals under 22 years
of age in an institution for mental diseases; and
(s) Hospice services.
(6) 'Medical assistance' includes any care or services for any
individual who is a patient in a medical institution or any care
or services for any individual who has attained 65 years of age
or is under 22 years of age, and who is a patient in a private or
public institution for mental diseases. 'Medical assistance '
includes 'health services' as defined in ORS 414.705. 'Medical
assistance' does not include care or services for an inmate in a
nonmedical public institution.
(7) 'Medically needy' means a person who is a resident of this
state and who is considered eligible under federal law for
medically needy assistance.
(8) 'Resources' has the meaning given that term in ORS 411.704.
For eligibility purposes, 'resources' does not include charitable
contributions raised by a community to assist with medical
expenses.
SECTION 5. ORS 414.065 is amended to read:
414.065. (1)(a) { - With respect to medical and remedial care
and services to be provided in medical assistance during any
period, and within the limits of funds available therefor, the
Oregon Health Authority shall determine, subject to such
revisions as it may make from time to time and - } With respect
to the 'health services' defined in ORS 414.705 { - , subject to
legislative funding in response to the report of the Health
Services Commission and paragraph (b) of this subsection - }
{ + that are approved and funded by the Legislative Assembly
under ORS 414.720, the Oregon Health Authority shall
determine + }:
(A) The types and extent of medical and remedial care and
services to be provided to each eligible group of recipients of
medical assistance.
(B) Standards to be observed in the provision of medical and
remedial care and services.
(C) The number of days of medical and remedial care and
services toward the cost of which public assistance funds will be
expended in the care of any person.
(D) Reasonable fees, charges and daily rates to which public
assistance funds will be applied toward meeting the costs of
providing medical and remedial care and services to an applicant
or recipient.
(E) Reasonable fees for professional medical and dental
services which may be based on usual and customary fees in the
locality for similar services.
(F) The amount and application of any copayment or other
similar cost-sharing payment that the authority may require a
recipient to pay toward the cost of medical and remedial care or
services.
(b) { - Notwithstanding ORS 414.720 (8), - } The authority
shall adopt rules establishing timelines for payment of health
services under paragraph (a) of this subsection.
{ - (2) The types and extent of medical and remedial care and
services and the amounts to be paid in meeting the costs thereof,
as determined and fixed by the authority and within the limits of
funds available therefor, shall be the total available for
medical assistance and payments for such medical assistance shall
be the total amounts from public assistance funds available to
providers of medical and remedial care and services in meeting
the costs thereof. - }
{ - (3) - } { + (2) + } Except for payments under a
cost-sharing plan, payments made by the authority for medical
assistance shall constitute payment in full for all medical and
remedial care and services for which such payments of medical
assistance were made.
{ - (4) - } { + (3) + } Medical benefits, standards and
limits established pursuant to subsection (1)(a)(A), (B) and (C)
of this section for
{ - the eligible medically needy, except for persons receiving
assistance under ORS 411.706, - } { + persons described in ORS
414.706 (5) + } may be less than { - but may not exceed - }
medical benefits, standards and limits established for { - the
eligible categorically needy, except that, in the case of a
research and demonstration project entered into under ORS
411.135, medical benefits, standards and limits for the eligible
medically needy may exceed those established for specific
eligible groups of the categorically needy - } { + persons
described in ORS 414.706 (1), (2) and (3) + }.
SECTION 6. ORS 414.705 is amended to read:
414.705. (1) As used in ORS 414.705 to 414.750, 'health
services' means at least so much of each of the following as are
approved and funded by the Legislative Assembly { + under ORS
414.720 + }:
(a) Services required by federal law to be included in the
state's medical assistance program in order for the program to
qualify for federal funds;
(b) Services provided by a physician as defined in ORS 677.010,
a nurse practitioner certified under ORS 678.375 or other
licensed practitioner within the scope of the practitioner's
practice as defined by state law, and ambulance services;
(c) Prescription drugs;
(d) Laboratory and X-ray services;
(e) Medical supplies;
(f) Mental health services;
(g) Chemical dependency services;
(h) Emergency dental services;
(i) Nonemergency dental services;
(j) Provider services, other than services described in
paragraphs (a) to (i), (k), (L) and (m) of this subsection,
defined by federal law that may be included in the state's
medical assistance program;
(k) Emergency hospital services;
(L) Outpatient hospital services; and
(m) Inpatient hospital services.
(2) Health services approved and funded under subsection (1) of
this section are subject to the prioritized list of health
services required in ORS 414.720.
SECTION 7. ORS 414.706 is amended to read:
414.706. { - The Legislative Assembly shall approve and fund
health services to the following - } Persons { + who are
eligible for medical assistance include, but are not limited
to + }:
(1) Persons who are categorically needy as described in ORS
414.025 (2)(o) and (p);
(2) Pregnant women with incomes no more than { - 185 - }
{ + 200 + } percent of the federal poverty guidelines;
(3) Persons under 19 years of age with incomes no more than 200
percent of the federal poverty guidelines;
(4) Persons described in ORS 414.708; and
(5) Persons 19 years of age or older with incomes no more than
100 percent of the federal poverty guidelines who do not have
federal Medicare coverage.
SECTION 8. ORS 414.708 is amended to read:
414.708. (1) A person is eligible to receive the health
services described in ORS { - 414.707 (2) - } { + 414.705
(1)(c), (f) and (g) + } when the person is a resident of this
state who:
(a) Is 65 years of age or older, or is blind or has a
disability as those terms are defined in ORS 411.704;
(b) Has a gross annual income that does not exceed the standard
established by the Oregon Health Policy Board; and
(c) Is not covered under any public or private prescription
drug benefit program.
(2) A person receiving prescription drug services under
{ - ORS 414.707 (2) - } { + subsection (1) of this section + }
shall pay up to a percentage of the Medicaid price of the
prescription drug established by the authority by rule and the
dispensing fee.
SECTION 9. ORS 414.709 is amended to read:
414.709. (1) Except as provided in subsection (2) of this
section, if insufficient resources are available during a
biennium, the population of eligible persons receiving health
services may not be reduced below the population of eligible
persons approved and funded in the legislatively adopted budget
for the Oregon Health Authority for the biennium.
(2) The Oregon Health Authority may periodically limit
enrollment { + in medical assistance + } of persons described in
ORS { + 414.025 (2)(s) and + } 414.708 { + and participation
in the program under ORS 414.231 (2)(b) + } in order to stay
within the legislatively adopted budget for the authority.
SECTION 10. ORS 414.712 is amended to read:
414.712. The Oregon Health Authority shall provide medical
assistance { - under ORS 414.705 to 414.750 - } to eligible
persons who are determined eligible for medical assistance by the
Department of Human Services according to ORS 411.706. The Oregon
Health Authority shall also provide the following:
(1) Ombudsman services for eligible persons who receive
assistance under ORS 411.706. With the concurrence of the
Governor and the Oregon Health Policy Board, the Director of the
Oregon Health Authority shall appoint ombudsmen and may terminate
an ombudsman. Ombudsmen are under the supervision and control of
the director. An ombudsman shall serve as a patient's advocate
whenever the patient or a physician or other medical personnel
serving the patient is reasonably concerned about access to,
quality of or limitations on the care being provided by a health
care provider. Patients shall be informed of the availability of
an ombudsman. Ombudsmen shall report to the Governor and the
Oregon Health Policy Board in writing at least once each quarter.
A report shall include a summary of the services that the
ombudsman provided during the quarter and the ombudsman's
recommendations for improving ombudsman services and access to or
quality of care provided to eligible persons by health care
providers.
(2) Case management services in each health care provider
organization for those eligible persons who receive assistance
under ORS 411.706. Case managers shall be trained in and shall
exhibit skills in communication with and sensitivity to the
unique health care needs of people who receive assistance under
ORS 411.706. Case managers shall be reasonably available to
assist patients served by the organization with the coordination
of the patient's health care services at the reasonable request
of the patient or a physician or other medical personnel serving
the patient. Patients shall be informed of the availability of
case managers.
(3) A mechanism, established by rule, for soliciting consumer
opinions and concerns regarding accessibility to and quality of
the services of each health care provider.
(4) A choice of available medical plans and, within those
plans, choice of a primary care provider.
(5) Due process procedures for any individual whose request for
medical assistance coverage for any treatment or service is
denied or is not acted upon with reasonable promptness. These
procedures shall include an expedited process for cases in which
a patient's medical needs require swift resolution of a dispute.
SECTION 11. ORS 414.720 is amended to read:
414.720. (1) The Health Services Commission shall conduct
public hearings prior to making the report described in
subsection (3) of this section. The commission shall solicit
testimony and information from advocates representing seniors,
persons with disabilities, mental health services consumers and
low-income Oregonians, representatives of commercial carriers,
representatives of small and large Oregon employers and providers
of health care, including but not limited to physicians licensed
to practice medicine, dentists, oral surgeons, chiropractors,
naturopaths, hospitals, clinics, pharmacists, nurses and allied
health professionals.
(2) The commission shall actively solicit public involvement in
a community meeting process to build a consensus on the values to
be used to guide health resource allocation decisions.
(3) The commission shall report to the Governor a list of
health services ranked by priority, from the most important to
the least important, representing the comparative benefits of
each service to the entire population to be served. The list
submitted by the commission pursuant to this subsection is not
subject to alteration by any other state agency. The
recommendation may include practice guidelines reviewed and
adopted by the commission pursuant to subsection (4) of this
section.
(4) In order to encourage effective and efficient medical
evaluation and treatment, the commission:
(a) May include clinical practice guidelines in its prioritized
list of services. The commission shall actively solicit testimony
and information from the medical community and the public to
build a consensus on clinical practice guidelines developed by
the commission.
(b) Shall consider both the clinical effectiveness and
cost-effectiveness of health services in determining their
relative importance using peer-reviewed medical literature as
defined in ORS 743A.060.
(5) The commission shall make its report by July 1 of the year
preceding each regular session of the Legislative Assembly and
shall submit a copy of its report to the Governor, the Speaker of
the House of Representatives and the President of the Senate.
{ + (6) Medical assistance provided pursuant to ORS 411.404,
414.065, 414.706 and 414.712 shall cover all health services on
the list described in subsection (3) of this section to the level
approved and funded by the Legislative Assembly. + }
{ - (6) - } { + (7) + } The commission may alter the list
during interim only under the following conditions:
(a) Technical changes due to errors and omissions; and
(b) Changes due to advancements in medical technology or new
data regarding health outcomes.
{ - (7) - } { + (8) + } If a service is deleted or added
and no new funding is required, the { - commission - } { +
Oregon Health Authority + } shall report to the Speaker of the
House of Representatives and the President of the Senate.
However, if a service to be added requires increased funding to
avoid discontinuing another service, the
{ - commission - } { + authority + } must report to the
Emergency Board to request the funding.
{ - (8) - } { + (9) + } The { - report listing - } { +
list of health + } services { - to be provided pursuant to ORS
411.404, 414.065, 414.705 to 414.725 and 414.735 to 414.750 - }
shall remain in effect from October 1 of the odd-numbered year
through September 30 of the next odd-numbered year.
SECTION 12. ORS 414.725 is amended to read:
414.725. (1)(a) Pursuant to rules adopted by the Oregon Health
Authority, the authority shall execute prepaid managed care
health services contracts for health services { + approved
and + } funded by the Legislative Assembly { + under ORS
414.720 + }. { + Subject to ORS 414.735 and 414.740, + } the
contract must require { - that all services are provided to the
extent and scope of the Health Services Commission's report for
each service provided under the contract - } { + coverage of
all health services approved and funded by the Legislative
Assembly under ORS 414.720 + }. The contracts are not subject to
ORS chapters 279A and 279B, except ORS 279A.250 to 279A.290 and
279B.235. { - Notwithstanding ORS 414.720 (8), - } The rules
adopted by the authority shall establish timelines for executing
the contracts described in this paragraph.
(b) { - It is the intent of ORS 414.705 to 414.750 that the
state - } { + The authority shall + } use, to the greatest
extent possible, prepaid managed care health services
organizations to provide
{ - physical health, dental, mental health and chemical
dependency services under ORS 414.705 to 414.750 - } { + health
services + }.
(c) The authority shall solicit qualified providers or plans to
be reimbursed for providing the covered services. The contracts
may be with hospitals and medical organizations, health
maintenance organizations, managed health care plans and any
other qualified public or private prepaid managed care health
services organization. The authority may not discriminate against
any contractors that offer services within their providers'
lawful scopes of practice.
(d) The authority shall establish annual financial reporting
requirements for prepaid managed care health services
organizations. The authority shall prescribe a reporting
procedure that elicits sufficiently detailed information for the
authority to assess the financial condition of each prepaid
managed care health services organization and that includes
information on the three highest executive salary and benefit
packages of each prepaid managed care health services
organization.
(e) The authority shall require compliance with the provisions
of paragraph (d) of this subsection as a condition of entering
into a contract with a prepaid managed care health services
organization.
(f)(A) The authority shall adopt rules and procedures to ensure
that a rural health clinic that provides a health service to an
enrollee of a prepaid managed care health services organization
receives total aggregate payments from the organization, other
payers on the claim and the authority that are no less than the
amount the rural health clinic would receive in the authority's
fee-for-service payment system. The authority shall issue a
payment to the rural health clinic in accordance with this
subsection within 45 days of receipt by the authority of a
completed billing form.
(B) 'Rural health clinic,' as used in this paragraph, shall be
defined by the authority by rule and shall conform, as far as
practicable or applicable in this state, to the definition of
that term in 42 U.S.C. 1395x(aa)(2).
(2) The authority may institute a fee-for-service case
management system or a fee-for-service payment system for the
{ - same physical health, dental, mental health or chemical
dependency - } { + health + } services provided under { - the
health services contracts for persons eligible for health
services under ORS 414.705 to 414.750 - } { + medical
assistance + } in { - designated - } areas of the state in
which a prepaid managed care health services organization is not
able to assign an enrollee to a person { - or entity - } that
is primarily responsible for coordinating the
{ - physical health, dental, mental health or chemical
dependency - } { + enrollee's health + } services { - provided
to the enrollee - } . In addition, the authority may make other
special arrangements as necessary to increase the interest of
providers in participation in the state's managed care system,
including but not limited to the provision of stop-loss insurance
for providers wishing to limit the amount of risk they wish to
underwrite.
(3) As provided in subsections (1) and (2) of this section, the
aggregate expenditures by the authority for health services
{ - provided pursuant to ORS 414.705 to 414.750 - } may not
exceed the total dollars appropriated for health services
{ - under ORS 414.705 to 414.750 - } .
(4) Actions taken by providers, potential providers,
contractors and bidders in specific accordance with ORS 414.705
to 414.750 in forming consortiums or in otherwise entering into
contracts to provide health care services shall be performed
pursuant to state supervision and shall be considered to be
conducted at the direction of this state, shall be considered to
be lawful trade practices and may not be considered to be the
transaction of insurance for purposes of the Insurance Code.
(5) Health care providers contracting to provide
{ + health + } services { - under ORS 414.705 to 414.750 - }
shall advise a patient of any service, treatment or test that is
medically necessary but not covered under the contract if an
ordinarily careful practitioner in the same or similar community
would do so under the same or similar circumstances.
(6) A prepaid managed care health services organization shall
provide information on contacting available providers to an
enrollee in writing within 30 days of assignment to the health
services organization.
(7) Each prepaid managed care health services organization
shall provide upon the request of an enrollee or prospective
enrollee annual summaries of the organization's aggregate data
regarding:
(a) Grievances and appeals; and
(b) Availability and accessibility of services provided to
enrollees.
(8) A prepaid managed care health services organization may not
limit enrollment in a designated area based on the zip code of an
enrollee or prospective enrollee.
SECTION 13. ORS 414.735 is amended to read:
414.735. (1) If insufficient resources are available during a
contract period:
(a) The population of eligible persons determined by law shall
not be reduced.
(b) The reimbursement rate for providers and plans established
under the contractual agreement shall not be reduced.
(2) In the circumstances described in subsection (1) of this
section, reimbursement shall be adjusted by reducing the health
services for the eligible population by eliminating services in
the order of priority recommended by the Health Services
Commission, starting with the least important and progressing
toward the most important.
(3) The Oregon Health Policy Board shall obtain the approval of
the Legislative Assembly, or the Emergency Board if the
Legislative Assembly is not in session, before instituting the
reductions. In addition, providers contracting to provide health
services { - under ORS 414.705 to 414.750 - } must be notified
at least two weeks prior to any legislative consideration of such
reductions. Any reductions made under this section shall take
effect no sooner than 60 days following final legislative action
approving the reductions.
(4) This section does not apply to reductions made by the
Legislative Assembly in a legislatively adopted or approved
budget.
SECTION 14. ORS 414.737 is amended to read:
414.737. (1) Except as provided in subsections (2) and (3) of
this section, a person who is eligible for or receiving
{ - physical health, dental, mental health or chemical
dependency services under ORS 414.705 to 414.750 - }
{ + medical assistance + } must be enrolled in the prepaid
managed care health services organizations to receive the health
services for which the person is eligible.
(2) Subsection (1) of this section does not apply to:
(a) A person who { + , because of the person's immigration
status, + } is { - a noncitizen and who is - } eligible only
for labor and delivery services and emergency treatment services;
(b) A person who is an American Indian and Alaskan Native
beneficiary; and
(c) A person whom the Oregon Health Authority may by rule
exempt from the mandatory enrollment requirement of subsection
(1) of this section, including but not limited to:
(A) A person who is also eligible for Medicare;
(B) A woman in her third trimester of pregnancy at the time of
enrollment;
(C) A person under 19 years of age who has been placed in
adoptive or foster care out of state;
(D) A person under 18 years of age who is medically fragile and
who has special health care needs; and
(E) A person with major medical coverage.
(3) Subsection (1) of this section does not apply to a person
who resides in a designated area in which a prepaid managed care
health services organization providing { - physical health,
dental, mental health or chemical dependency - } { + health + }
services is not able to assign an enrollee to a person or entity
that is primarily responsible for coordinating the { - physical
health, dental, mental health or chemical dependency - }
{ + health + } services provided to the enrollee.
(4) As used in this section, 'American Indian and Alaskan
Native beneficiary' means:
(a) A member of a federally recognized Indian tribe, band or
group;
(b) An Eskimo or Aleut or other Alaskan Native enrolled by the
United States Secretary of the Interior pursuant to the Alaska
Native Claims Settlement Act, 43 U.S.C. 1601; or
(c) A person who is considered by the United States Secretary
of the Interior to be an Indian for any purpose.
SECTION 15. ORS 414.737, as amended by section 8, chapter 751,
Oregon Laws 2007, and section 331, chapter 595, Oregon Laws 2009,
is amended to read:
414.737. (1) Except as provided in subsections (2) and (3) of
this section, a person who is eligible for or receiving
{ - physical health, dental, mental health or chemical
dependency services under ORS 414.705 to 414.750 - }
{ + medical assistance + } must be enrolled in the prepaid
managed care health services organizations to receive the health
services for which the person is eligible.
(2) Subsection (1) of this section does not apply to:
(a) A person who { + , because of the person's immigration
status, + } is { - a noncitizen and who is - } eligible only
for labor and delivery services and emergency treatment services;
(b) A person who is an American Indian and Alaskan Native
beneficiary; and
(c) A person whom the Oregon Health Authority may by rule
exempt from the mandatory enrollment requirement of subsection
(1) of this section, including but not limited to:
(A) A person who is also eligible for Medicare;
(B) A woman in her third trimester of pregnancy at the time of
enrollment;
(C) A person under 19 years of age who has been placed in
adoptive or foster care out of state;
(D) A person under 18 years of age who is medically fragile and
who has special health care needs; { + and + }
{ - (E) A person receiving services under the Medically
Involved Home-Care Program created by ORS 417.345 (1); and - }
{ - (F) - } { + (E) + } A person with major medical
coverage.
(3) Subsection (1) of this section does not apply to a person
who resides in a designated area in which a prepaid managed care
health services organization providing { - physical health,
dental, mental health or chemical dependency - } { + health + }
services is not able to assign an enrollee to a person or entity
that is primarily responsible for coordinating the { - physical
health, dental, mental health or chemical dependency - }
{ + health + } services provided to the enrollee.
(4) As used in this section, 'American Indian and Alaskan
Native beneficiary' means:
(a) A member of a federally recognized Indian tribe, band or
group;
(b) An Eskimo or Aleut or other Alaskan Native enrolled by the
United States Secretary of the Interior pursuant to the Alaska
Native Claims Settlement Act, 43 U.S.C. 1601; or
(c) A person who is considered by the United States Secretary
of the Interior to be an Indian for any purpose.
SECTION 16. ORS 414.738 is amended to read:
414.738. (1) If the Oregon Health Authority has not been able
to contract with the fully capitated health plan or plans in a
designated area, the authority may contract with a physician care
organization in the designated area.
(2) The Office for Oregon Health Policy and Research shall
develop criteria that the authority shall consider when
determining the circumstances under which the authority may
contract with a physician care organization. The criteria
developed by the office shall include but not be limited to the
following:
(a) The physician care organization must be able to assign an
enrollee to a person or entity that is primarily responsible for
coordinating the physical health services provided to the
enrollee;
(b) The contract with a physician care organization does not
threaten the financial viability of other fully capitated health
plans in the designated area; and
(c) The contract with a physician care organization must be
consistent with the legislative intent of using prepaid managed
care health services organizations to provide { + health + }
services
{ - under ORS 414.705 to 414.750 - } .
SECTION 17. ORS 414.739 is amended to read:
414.739. (1) A fully capitated health plan may apply to the
Oregon Health Authority to contract with the authority as a
physician care organization rather than as a fully capitated
health plan to provide { + health + } services { - under ORS
414.705 to 414.750 - } .
(2) The Office for Oregon Health Policy and Research shall
develop the criteria that the authority must use to determine the
circumstances under which the authority may accept an application
by a fully capitated health plan to contract as a physician care
organization. The criteria developed by the office shall include
but not be limited to the following:
(a) The fully capitated health plan must show documented losses
due to hospital risk and must show due diligence in managing
those risks; and
(b) Contracting as a physician care organization is financially
viable for the fully capitated health plan.
SECTION 18. ORS 414.740 is amended to read:
414.740. (1) Notwithstanding ORS 414.738 (1), the Oregon Health
Authority shall contract under ORS 414.725 with a prepaid group
practice health plan that serves at least 200,000 members in this
state and that has been issued a certificate of authority by the
Department of Consumer and Business Services as a health care
service contractor to provide health services as described in ORS
414.705 (1)(b), (c), (d), (e), (g) and (j). A health plan may
also contract with the authority on a prepaid capitated basis to
provide the health services described in ORS 414.705 (1)(k) and
(L). The authority may accept financial contributions from any
public or private entity to help implement and administer the
contract. The authority shall seek federal matching funds for any
financial contributions received under this section.
(2) In a designated area, in addition to the contract described
in subsection (1) of this section, the authority shall contract
with prepaid managed care health services organizations to
provide health services { - under ORS 414.705 to 414.750 - } .
SECTION 19. ORS 414.741 is amended to read:
414.741. (1) The Health Services Commission shall retain an
actuary to determine the benchmark for setting per capita rates
necessary to reimburse prepaid managed care health services
organizations and fee-for-service providers for the cost of
providing health services { - under ORS 414.705 to 414.750 - }
.
(2) The actuary retained by the commission shall use the
following information to determine the benchmark for setting per
capita rates:
(a) For hospital services, the most recently available Medicare
cost reports for Oregon hospitals;
(b) For services of physicians licensed under ORS chapter 677
and other health professionals using procedure codes, the
Medicare Resource Based Relative Value system conversion rates
for Oregon;
(c) For prescription drugs, the most recent payment
methodologies in the fee-for-service payment system for the
medical assistance program;
(d) For durable medical equipment and supplies, 80 percent of
the Medicare allowable charge for purchases and rentals;
(e) For dental services, the most recent payment rates obtained
from dental care organization encounter data; and
(f) For all other services not listed in paragraphs (a) to (e)
of this subsection:
(A) The Medicare maximum allowable charge, if available; or
(B) The most recent payment rates obtained from the data
available under subsection (3) of this section.
(3) The actuary shall use the most current encounter data and
the most current fee-for-service data that is available,
reasonable trends for utilization and cost changes to the
midpoint of the next biennium, appropriate differences in
utilization and cost based on geography, state and federal
mandates and other factors that, in the professional judgment of
the actuary, are relevant to the fair and reasonable estimation
of costs. The Department of Human Services shall provide the
actuary with the data and information in the possession of the
department or contractors of the department reasonably necessary
to develop a benchmark for setting per capita rates.
(4) The commission shall report the benchmark per capita rates
developed under this section to the Director of the Oregon
Department of Administrative Services, the Director of the Oregon
Health Authority and the Legislative Fiscal Officer no later than
August 1 of every even-numbered year.
(5) The Oregon Health Authority shall retain an actuary to
determine:
(a) Per capita rates for health services that the authority
shall use to develop the authority's proposed biennial budget;
and
(b) Capitation rates to reimburse physician care organizations
for the cost of providing health services { - under ORS 414.705
to 414.750 - } using the same methodologies used to develop
capitation rates for fully capitated health plans. The rates may
not advantage or disadvantage fully capitated health plans for
similar services.
(6) The Oregon Health Authority shall submit to the Legislative
Assembly no later than February 1 of every odd-numbered year a
report comparing the per capita rates for health services on
which the proposed budget of the authority is based with the
rates developed by the actuary retained by the Health Services
Commission. If the rates differ, the authority shall disclose, by
provider categories described in subsection (2) of this section,
the amount of and reason for each variance.
SECTION 20. ORS 414.428 is amended to read:
414.428. (1) An individual described in ORS 414.025 (2)(s) who
is eligible for or receiving medical assistance and who is an
American Indian and Alaskan Native beneficiary shall receive
{ - the benefit package of health care services described in ORS
414.707 (1) - } { + all the health services approved and funded
by the Legislative Assembly + } if:
(a) The Oregon Health Authority receives 100 percent federal
medical assistance percentage for payments made by the authority
for the health { - care - } services { - provided as part of
the benefit package described in ORS 414.707 (1) - } ; or
(b) The authority receives funding from the Indian tribes for
which federal financial participation is available.
(2) As used in this section, 'American Indian and Alaskan
Native beneficiary' means:
(a) A member of a federally recognized Indian tribe, band or
group;
(b) An Eskimo or Aleut or other Alaskan native enrolled by the
United States Secretary of the Interior pursuant to the Alaska
Native Claims Settlement Act, 43 U.S.C. 1601; or
(c) A person who is considered by the United States Secretary
of the Interior to be an Indian for any purpose.
SECTION 21. ORS 414.842 is amended to read:
414.842. (1) There is established the Family Health Insurance
Assistance Program in the Office of Private Health Partnerships.
The purpose of the program is to remove economic barriers to
health insurance coverage for residents of the State of Oregon
with family income { - less than - } { + at or below + } 200
percent of the federal poverty level { - , and investment and
savings less than the limit established by the office, - } while
encouraging individual responsibility, promoting health benefit
plan coverage of children, building on the private sector health
benefit plan system and encouraging employer and employee
participation in employer-sponsored health benefit plan coverage.
(2) The Office of Private Health Partnerships shall be
responsible for the implementation and operation of the Family
Health Insurance Assistance Program. The Administrator of the
Office for Oregon Health Policy and Research, in consultation
with the Oregon Health Policy Board, shall make recommendations
to the Office of Private Health Partnerships regarding program
policy, including but not limited to eligibility requirements,
assistance levels, benefit criteria and carrier participation.
(3) The Office of Private Health Partnerships may contract with
one or more third-party administrators to administer one or more
components of the Family Health Insurance Assistance Program.
Duties of a third-party administrator may include but are not
limited to:
(a) Eligibility determination;
(b) Data collection;
(c) Assistance payments;
(d) Financial tracking and reporting; and
(e) Such other services as the office may deem necessary for
the administration of the program.
(4) If the office decides to enter into a contract with a
third-party administrator pursuant to subsection (3) of this
section, the office shall engage in competitive bidding. The
office shall evaluate bids according to criteria established by
the office, including but not limited to:
(a) The bidder's proven ability to administer a program of the
size of the Family Health Insurance Assistance Program;
(b) The efficiency of the bidder's payment procedures;
(c) The estimate provided of the total charges necessary to
administer the program; and
(d) The bidder's ability to operate the program in a
cost-effective manner.
SECTION 22. ORS 735.625 is amended to read:
735.625. (1) Except as provided in subsection (3)(c) of this
section, the Oregon Medical Insurance Pool Board shall offer
major medical expense coverage to every eligible person.
(2) The coverage to be issued by the board, its schedule of
benefits, exclusions and other limitations, shall be established
through rules adopted by the board, taking into consideration the
advice and recommendations of the pool members. In the absence of
such rules, the pool shall adopt by rule the minimum benefits
prescribed by section 6 (Alternative 1) of the Model Health
Insurance Pooling Mechanism Act of the National Association of
Insurance Commissioners (1984).
(3)(a) In establishing portability coverage under the pool, the
board shall consider the levels of medical insurance provided in
this state and medical economic factors identified by the board.
The board may adopt rules to establish benefit levels,
deductibles, coinsurance factors, exclusions and limitations that
the board determines are equivalent to the portability health
benefit plans established under ORS 743.760.
(b) In establishing medical insurance coverage under the pool,
the board shall consider the levels of medical insurance provided
in this state and medical economic factors identified by the
board. The board may adopt rules to establish benefit levels,
deductibles, coinsurance factors, exclusions and limitations that
the board determines are equivalent to those found in the
commercial group or employer-based medical insurance market.
(c) The board may provide a separate Medicare supplement policy
for individuals under the age of 65 who are receiving Medicare
disability benefits. The board shall adopt rules to establish
benefits, deductibles, coinsurance, exclusions and limitations,
premiums and eligibility requirements for the Medicare supplement
policy.
(d) In establishing medical insurance coverage for persons
eligible for coverage under ORS 735.615 (1)(d), the board shall
consider the levels of medical insurance provided in this state
and medical economic factors identified by the board. The board
may adopt rules to establish benefit levels, deductibles,
coinsurance factors, exclusions and limitations to create benefit
plans that qualify the person for the credit for health insurance
costs under section 35 of the federal Internal Revenue Code, as
amended and in effect on December 31, 2004.
(4)(a) Premiums charged for coverages issued by the board may
not be unreasonable in relation to the benefits provided, the
risk experience and the reasonable expenses of providing the
coverage.
(b) Separate schedules of premium rates based on age and
geographical location may apply for individual risks.
(c) The board shall determine the applicable medical and
portability risk rates either by calculating the average rate
charged by insurers offering coverages in the state comparable to
the pool coverage or by using reasonable actuarial techniques.
The risk rates shall reflect anticipated experience and expenses
for such coverage. Rates for pool coverage may not be more than
125 percent of rates established as applicable for medically
eligible individuals or for persons eligible for pool coverage
under ORS 735.615 (1)(d), or 100 percent of rates established as
applicable for portability eligible individuals.
(d) The board shall annually determine adjusted benefits and
premiums. The adjustments shall be in keeping with the purposes
of ORS 735.600 to 735.650, subject to a limitation of keeping
pool losses under one percent of the total of all medical
insurance premiums, subscriber contract charges and 110 percent
of all benefits paid by member self-insurance arrangements. The
board may determine the total number of persons that may be
enrolled for coverage at any time and may permit and prohibit
enrollment in order to maintain the number authorized. Nothing in
this paragraph authorizes the board to prohibit enrollment for
any reason other than to control the number of persons in the
pool.
(5)(a) The board may apply:
(A) A waiting period of not more than 90 days during which the
person has no available coverage; or
(B) Except as provided in paragraph (c) of this subsection, a
preexisting conditions provision of not more than six months from
the effective date of coverage under the pool.
(b) In determining whether a preexisting conditions provision
applies to an eligible enrollee, except as provided in this
subsection, the board shall credit the time the eligible enrollee
was covered under a previous health benefit plan if the previous
health benefit plan was continuous to a date not more than 63
days prior to the effective date of the new coverage under the
Oregon Medical Insurance Pool, exclusive of any applicable
waiting period. The Oregon Medical Insurance Pool Board need not
credit the time for previous coverage to which the insured or
dependent is otherwise entitled under this subsection with
respect to benefits and services covered in the pool coverage
that were not covered in the previous coverage.
(c) The board may adopt rules applying a preexisting conditions
provision to a person who is eligible for coverage under ORS
735.615 (1)(d).
(d) For purposes of this subsection, a 'preexisting conditions
provision' means a provision that excludes coverage for services,
charges or expenses incurred during a specified period not to
exceed six months following the insured's effective date of
coverage, for a condition for which medical advice, diagnosis,
care or treatment was recommended or received during the
six-month period immediately preceding the insured's effective
date of coverage.
(6)(a) Benefits otherwise payable under pool coverage shall be
reduced by all amounts paid or payable through any other health
insurance, or self-insurance arrangement, and by all hospital and
medical expense benefits paid or payable under any workers'
compensation coverage, automobile medical payment or liability
insurance whether provided on the basis of fault or nonfault, and
by any hospital or medical benefits paid or payable under or
provided pursuant to any state or federal law or program except
{ - the Medicaid portion of the medical assistance program
offering a level of health services described in ORS 414.707 - }
{ + medical assistance + }.
(b) The board shall have a cause of action against an eligible
person for the recovery of the amount of benefits paid which are
not for covered expenses. Benefits due from the pool may be
reduced or refused as a setoff against any amount recoverable
under this paragraph.
(7) Except as provided in ORS 735.616, no mandated benefit
statutes apply to pool coverage under ORS 735.600 to 735.650.
(8) Pool coverage may be furnished through a health care
service contractor or such alternative delivery system as will
contain costs while maintaining quality of care.
SECTION 23. { + The amendments to ORS 414.826, 414.841,
414.842 and 414.844 by sections 1 to 3 of this 2011 Act become
operative January 1, 2012. + }
SECTION 24. { + ORS 414.707 is repealed. + }
SECTION 25. { + 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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