Bill Text: OR SB683 | 2013 | Regular Session | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to health care practitioner referrals to health care entities.

Spectrum: Committee Bill

Status: (Passed) 2013-07-03 - Effective date, January 1, 2014. [SB683 Detail]

Download: Oregon-2013-SB683-Engrossed.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 2625

                           B-Engrossed

                         Senate Bill 683
                   Ordered by the House June 3
 Including Senate Amendments dated April 22 and House Amendments
                          dated June 3

Sponsored by COMMITTEE ON GENERAL GOVERNMENT, CONSUMER AND SMALL
  BUSINESS PROTECTION

                             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.

  Prohibits health care practitioners from limiting referrals of
patients to health care entities in which practitioner or
practitioner's family member has financial interest or employment
relationship.
  Requires full disclosure of financial interests or employment
relationship of practitioner. Requires practitioner to inform
patient, { +  in form and manner prescribed by Oregon Health
Authority, + } regarding patient choice. Makes failure to
disclose interest, relationship or notice of patient choice in
conjunction with lawful referral subject to civil penalty not to
exceed $1,000.
  Authorizes Oregon Health Licensing Agency or health
professional regulatory board to investigate and discipline
violations of Act.

                        A BILL FOR AN ACT
Relating to health care practitioner referrals to health care
  entities; creating new provisions; and amending ORS 441.098.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 441.098 is amended to read:
  441.098. (1) As used in this section { +  and sections 2 and 3
of this 2013 Act + }:
  (a) 'Facility' means a hospital,  { + outpatient clinic owned
by a hospital, + } ambulatory surgical center { + , + }
 { - or - }  freestanding birthing center { +  or facility that
receives Medicare reimbursement as an independent diagnostic
testing facility + }.
  (b) 'Financial interest' means a five percent or greater direct
or indirect ownership interest.
  (c) { + (A) + } 'Health practitioner' means a physician,
podiatric physician and surgeon, dentist, direct entry
midwife { + , + }   { - or - } licensed registered nurse who is
certified by the Oregon State Board of Nursing as a nurse midwife
nurse practitioner { + , certified nurse practitioner, licensed
physician assistant or medical imaging licensee under ORS 688.405
to 688.605 + }.
   { +  (B) 'Health practitioner' does not include a provider in
a health maintenance organization as defined in ORS 750.005. + }
  (d) 'Physician' has the meaning given that term in ORS 677.010.
   { +  (2) A health practitioner's decision to refer a patient
to a facility for a diagnostic test or health care treatment or
service shall be based on the patient's clinical needs and
personal health choices. + }
    { - (2) - }  { +  (3) + } If a health practitioner refers a
patient for  { + a diagnostic test or health care + } treatment
 { + or service + } at a facility in which the health
practitioner or an immediate family member  { + of the health
practitioner + } has a financial interest, the health
practitioner  { + or the practitioner's designee + } shall inform
the patient orally and in writing of that interest at the time of
the referral.
   { +  (4)(a) If a health practitioner refers a patient to a
facility for a diagnostic test or health care treatment or
service, the health practitioner or the practitioner's designee
shall inform the patient, in the form and manner prescribed by
the Oregon Health Authority by rule, that:
  (A) The patient may receive the test, treatment or service at a
different facility of the patient's choice; and
  (B) If the patient chooses a different facility, the patient
should contact the patient's insurer regarding the extent of
coverage or the limitations on coverage for the test, treatment
or service at the facility chosen by the patient.
  (b) Rules concerning the form and manner for informing a
patient as required by this subsection shall:
  (A) Be designed to ensure that the information is conveyed in a
timely and meaningful manner;
  (B) Be administratively simple; and
  (C) Accommodate a provider's adoption and use of electronic
health record systems.
  (5) A health practitioner may not deny, limit or withdraw a
referral to a facility solely for the reason that the patient
chooses to obtain the test, treatment or service from a different
facility.
  (6) The authority may not impose additional restrictions or
limitations on any referral described in this section that are in
addition to the requirements specified in subsections (3) and (4)
of this section. + }
    { - (3) - }  { +  (7) + } In obtaining informed consent
for { +  a diagnostic test or health care + } treatment { +  or
service + } that will take place at a facility, a health
practitioner shall disclose the manner in which care will be
provided in the event that complications occur that require
health services beyond what the facility has the capability to
provide.
   { +  (8) Subsections (3) to (5) of this section do not apply
to a referral for a diagnostic test or health care treatment or
service:
  (a) For a patient who is receiving inpatient hospital services
or services in an emergency department if the referral is for a
diagnostic test or health care treatment or service to be
performed while the patient is in the hospital or emergency
department;
  (b) Made to a particular facility after the initial referral of
the patient to that facility; or
  (c) Made by the facility or provider to whom a patient was
referred. + }
  SECTION 2.  { + (1) A health practitioner who fails to comply
with ORS 441.098 (2), (3), (4) or (5) shall be subject to
disciplinary action by the Oregon Health Licensing Agency or by
the appropriate health professional regulatory board as defined
in ORS 676.160.

  (2) The Oregon Health Licensing Agency or the appropriate
health professional regulatory board may investigate a claim
under ORS 441.098 in accordance with the investigative authority
granted under ORS 676.165. + }
  SECTION 3.  { + If the Oregon Health Licensing Agency or the
appropriate health professional regulatory board takes
disciplinary action under section 2 of this 2013 Act, the agency
or board may also impose a civil penalty of not more than $1,000
on a health practitioner for violating ORS 441.098 (2), (3), (4)
or (5). + }
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