Bill Text: OR SB98 | 2011 | Regular Session | Introduced
Bill Title: Relating to health care quality standards; declaring an emergency.
Sponsorship: Unknown
Status: (Failed) 2011-06-30 - In committee upon adjournment. [SB98 Detail]
Download: Oregon-2011-SB98-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 652
Senate Bill 98
Printed pursuant to Senate Interim Rule 213.28 by order of the
President of the Senate in conformance with presession filing
rules, indicating neither advocacy nor opposition on the part
of the President (at the request of Governor John A. Kitzhaber
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.
Requires Oregon Health Authority to adopt uniform, statewide
standards for reporting of health care quality information by
health care providers to insurers. Provides that insurers may not
require providers to submit information in addition to that
required by standards. Allows authority to contract with public
or private entities in adopting standards and guidelines for
health care data reporting. Exempts contracts from public
contracting requirements.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to health care quality standards; creating new
provisions; amending ORS 413.032; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 413.032 is amended to read:
413.032. (1) The Oregon Health Authority is established. The
authority shall:
(a) Carry out policies adopted by the Oregon Health Policy
Board;
(b) Develop a plan for the Oregon Health Insurance Exchange in
accordance with section 17, chapter 595, Oregon Laws 2009;
(c) Administer the Oregon Prescription Drug Program;
(d) Administer the Family Health Insurance Assistance Program;
(e) Provide regular reports to the board with respect to the
performance of health services contractors serving recipients of
medical assistance, including reports of trends in health
services and enrollee satisfaction;
(f) Guide and support, with the authorization of the board,
community-centered health initiatives designed to address
critical risk factors, especially those that contribute to
chronic disease;
(g) Be the state Medicaid agency for the administration of
funds from Titles XIX and XXI of the Social Security Act and
administer medical assistance under ORS chapter 414;
(h) In consultation with the Director of the Department of
Consumer and Business Services, periodically review and recommend
standards and methodologies to the Legislative Assembly for:
(A) Review of administrative expenses of health insurers;
(B) Approval of rates; and
(C) Enforcement of rating rules adopted by the Department of
Consumer and Business Services;
(i) Structure reimbursement rates for providers that serve
recipients of medical assistance to reward comprehensive
management of diseases, quality outcomes and the efficient use of
resources and to promote cost-effective procedures, services and
programs including, without limitation, preventive health, dental
and primary care services, web-based office visits, telephone
consultations and telemedicine consultations;
(j) Guide and support community three-share agreements in which
an employer, state or local government and an individual all
contribute a portion of a premium for a community-centered health
initiative or for insurance coverage; { - and - }
(k) Develop, in consultation with the Department of Consumer
and Business Services and the Health Insurance Reform Advisory
Committee, one or more products designed to provide more
affordable options for the small group market { + ; and
(L) Adopt by rule uniform, statewide standards for all
reporting of health care quality information by health care
providers to insurers, including standards stating that providers
may not be required by insurers, but may voluntarily agree, to
provide information beyond what is specified in the standards
adopted by the authority + }.
(2) The Oregon Health Authority is authorized to:
(a) Create an all-claims, all-payer database to collect health
care data and monitor and evaluate health care reform in Oregon
and to provide comparative cost and quality information to
consumers, providers and purchasers of health care about Oregon's
health care systems and health plan networks in order to provide
comparative information to consumers.
(b) { - Develop - } { + Adopt + } uniform contracting
standards for the purchase of health care, including the
following:
{ - (A) Uniform quality standards and performance
measures; - }
{ - (B) - } { + (A) + } Evidence-based guidelines for major
chronic disease management and health care services with
unexplained variations in frequency or cost;
{ - (C) - } { + (B) + } Evidence-based effectiveness
guidelines for select new technologies and medical equipment; and
{ - (D) - } { + (C) + } A statewide drug formulary that may
be used by publicly funded health benefit plans.
(c) { - Submit directly to the Legislative Counsel, no later
than October 1 of each even-numbered year, requests for measures
necessary to provide statutory authorization to carry out any of
the authority's duties or to implement any of the board's
recommendations. The measures may be filed prior to the beginning
of the legislative session in accordance with the rules of the
House of Representatives and the Senate - } { + Contract with
private or public entities as necessary for the adoption of
standards and guidelines under subsections (1)(L) and (2)(b)(A)
and (B) of this section. Such contracts are not subject to the
requirements of ORS chapter 279A, 279B or 279C + }.
(3) The enumeration of duties, functions and powers in this
section is not intended to be exclusive nor to limit the duties,
functions and powers imposed on or vested in the Oregon Health
Authority by ORS 413.006 to 413.064 or by other statutes.
SECTION 2. { + The amendments to ORS 413.032 by section 1 of
this 2011 Act become operative January 1, 2012. + }
SECTION 3. { + 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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