Bill Text: OR SB457 | 2013 | Regular Session | Engrossed

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Bill Title: Relating to health care.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2013-07-08 - In committee upon adjournment. [SB457 Detail]

Download: Oregon-2013-SB457-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 2966

                           A-Engrossed

                         Senate Bill 457
                 Ordered by the Senate April 22
           Including Senate Amendments dated April 22

Sponsored by Senator BATES

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.

    { - Requires Oregon Health Authority to report to
Seventy-eighth Legislative Assembly on changes necessary to
implement federal health care law. - }
    { - Declares emergency, effective on passage. - }  { +
  Prohibits insurer from denying coverage under health benefit
plan for covered services provided to person in custody of county
sheriff. Requires insurer to reimburse county sheriff for covered
services at no less than out-of-network provider rate.
  For medical services provided to person in custody of local
correctional facility, limits charges to keeper of facility to
amount no greater than Medicare rate as reimbursement for
services. + }

                        A BILL FOR AN ACT
Relating to health care; creating new provisions; and amending
  ORS 169.166.
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 the Insurance Code. + }
  SECTION 2.  { + (1) As used in this section, 'health benefit
plan' has the meaning given that term in ORS 743.730.
  (2) An insurer offering a health benefit plan may not deny
reimbursement for any service or supply covered by the plan or
cancel the coverage of an insured under the plan on the basis
that:
  (a) The insured is in the custody of a county sheriff's office;
  (b) The insured receives publicly funded medical care while in
the custody of a county sheriff's office; or
  (c) The care was provided to the insured by an employee of or
contractor with a county sheriff's office.
  (3) An insurer shall reimburse a county sheriff's office for
the costs of covered services or supplies provided to an insured
who is in the custody of the county sheriff's office in an amount
that is no less than the amount paid under the insured's health
benefit plan to other out-of-network providers for the same
services or supplies. + }
  SECTION 3. ORS 169.166 is amended to read:

  169.166. Notwithstanding ORS 169.140 and 169.150 and except as
otherwise provided in ORS 414.805 and 414.807:
  (1) An individual who receives medical services not provided by
the county or city while in the custody of a local correctional
facility or juvenile detention facility is liable:
  (a) To the provider of the medical services not provided by the
county or city for the charges and expenses therefor; and
  (b) To the keeper of the local correctional facility for any
charges or expenses paid by the keeper of the facility for the
medical services not provided by the county or city.
  (2) A person providing medical services not provided by the
county or city to an individual described in subsection (1)(a) of
this section shall first make reasonable efforts to collect the
charges and expenses thereof from the individual before seeking
to collect them from the keeper of the local correctional
facility.
  (3)(a) Except as otherwise provided in subsection (4) of this
section, if the provider has not been paid within 45 days of the
date of the billing, the provider may bill the keeper of the
local correctional facility who shall pay the account in
accordance with ORS 169.140 and 169.150. { +  If a provider bills
the keeper of a local correctional facility for a medical service
provided to an individual in the custody of the facility, the
provider may not bill for an amount that exceeds the amount that
Medicare reimburses for the service. + }
  (b) A bill submitted to the keeper of a local correctional
facility under this subsection must be accompanied by evidence
documenting that:
  (A) The provider has billed the individual or the individual's
insurer or health care service contractor for the charges or
expenses owed to the provider; and
  (B) The provider has made a reasonable effort to collect from
the individual or the individual's insurer or health care service
contractor the charges and expenses owed to the provider.
  (c) If the provider receives payment from the individual or the
insurer or health care service contractor after receiving payment
from the keeper of the facility, the provider shall repay the
keeper the amount received from the keeper less any difference
between payment received from the individual, insurer or
contractor and the amount of the billing.
  (4) Except as otherwise provided by ORS 30.260 to 30.300 and
federal civil rights laws, upon release of the individual from
the actual physical custody of the local correctional facility,
the keeper of the local correctional facility is not liable for
the payment of charges and expenses for medical services provided
to the individual.
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