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LEGISLATIVE UPDATE
Prepared for OAFP
April 23, 2017
Session Reaches Halfway Point
Last week marked the halfway point and the first major deadline of the session. Committees had to complete work on bills in the first chamber by the end of the day Tuesday, which resulted in long committee meetings. Dozens of bills were often quickly approved while others bit the dust.
Bills now shift to the second chamber, which must post work sessions by May 19 and have until Friday, June 2 to complete their work.
The Revenue Forecast which will be used as the basis for the 2017-19 budget is scheduled to be released on Tuesday, May 16.
SB 934 – Primary Care Payment Reform
The Senate Health Committee passed SB 934 unanimously this week with a new amendment. The bill, as amended, requires CCOs, commercial insurers and OEBB and PEBB to increase their spending on primary care by at least 1% annually, in order to reach 12% of their overall global budget or premium by 2023.
Insurers are okay with this amendment says Sen. Elizabeth Steiner Hayward (D-Portland) so long as she committed to amend on the bill on the House side if need be.
It now goes to the floor for debate.
HB 3261 – Workforce Incentives Fund goes to Ways & Means
The next step in the process to put all of the healthcare workforce incentive funds under one umbrella is headed to Ways and Means.
There was no discussion by the House Health Committee when they approved the bill. Amendments are still needed to clarify and correct language in the bill, and to give legislative direction to the Oregon Health Policy Board.
SB 737 – Damages Caps
This bill puts a $500,000 cap on non-economic damages in cases where catastrophic physical injuries are caused by others, including traumatic brain injury and paralysis, sexual assault and child abuse. It does not apply to wrongful death cases.
The Senate Judiciary Committee approved the bill on a party-line vote, sending it to the floor for debate.
HB 2387 – Rx Cost Controls
HB 2387 advanced out of the House Health Committee this week on a party line vote. The bill in its current form does a number of things to try to reduce the cost of pharmaceutical drugs at different levels of the health care system. For consumers, it caps out of pocket costs at $100 or $250 depending on one’s insurance plan. The bill also requires pharmaceutical companies to provide rebates to insurers when the price rises by a larger amount than the standard trend of 3.4% or a generic’s price exceeds the average price in other developed countries.
Though all the Republicans on the committee voted no on the bill with the amendment, they complemented Rep. Rob Nosse (D-Portland) on tackling such a tough issue. The bill now goes to Ways and Means.
SB 793 – Rx Price Reporting
SB 793 is now dead. Similar provisions live on in HB 2387 however. The bill would have required pharmaceutical manufacturers to report prices and increases to the Department of Consumer and Business Services. Those with increases greater than 3.4% would have to justify the prices through a rate review process. DCBS could require pharmaceutical manufacturers to rebate excessive price increases to purchasers.
HB 2979 – Limits OHP fee-for-service; CCO enrollment
This bill gets rid of certain exemptions of Medicaid recipients from enrolling in CCOs. The committee adopted an amendment that requires the OHA to enroll an eligible person in a CCO within 30-days.
The committee passed the bill. It now goes to Ways and Means.
SB 233 – CCO Global Budget Reporting
FamilyCare’s bill that would require the Oregon Health Authority to make public the information regarding their rate setting for CCOs passed out of the Senate Health Committee this week. It would also allow a CCO to appeal the OHA’s rates with DCBS, which oversees commercial insurers.
It now goes to the floor
SB 235, SB 998– Tobacco Retail Licensure
The Senate Health Committee moved SB 235 to the Senate Rules Committee to avoid the deadline. The bill would require tobacco retailers to be licensed. There is still debate about the details of licensure however—specifically how much the license would cost and who would enforce the law.
The tobacco retailer’s bill, SB 998, is now dead.
3 Options for Healthcare – Single Payer Study
Chapin White, RAND, laid out three different options for state funded health care. Those options included single payer, a Health Care Ingenuity Plan (HCIP), or a public option. The public option would be fairly simple to administer as the State already provides options like PEBB and OEBB. Single payer on the other hand would have to get around ARISA and maybe federal legislation.
“In order for a public option to be competitive with private rates, there needs to be savings somewhere, either administrative savings, or by paying lower rates. They suggest 90% of Medicare.”
The presentation also detailed what the funding mix for each option would be. Generally, each plan shifts costs from consumers in terms of premiums to costs in the form of taxes. This decreases costs for those under 250% of FPL and increases them for those above that level.
Sen. Michael Dembrow (D-Portland) said,” One of the goals of the single payer system is to increase access to primary care or to increase the use of primary care. How does Oregon reimburse providers relative to other states?”
White says there are many options to reduce provider reimbursement by 10% on average across the board.
Dembrow asked wouldn’t this reduce administrative burden for providers and hospitals as well?
White says it depends. “Would they have to bill for each service? Would hospitals be given global budgets?” In other words, the devil is in the details.
HB 2518 – Naloxone info to PDMP
This bill requires pharmacies to report de-identified information to the prescription drug monitoring program (PDMP) upon dispensing prescribed naloxone.
The committee passed the bill with an amendment that requires all prescribers to enroll in the PDMP. It now goes to Ways and Means.
SB 494 – Advance Directives
This bill creates a 13-member Advance Directive Rules Adoption Committee. It requires the first form adopted by the committee be submitted to the Legislature for approval.
Sen. Kim Thatcher (R-Keizer) opposed the bill saying, “I would rather that any substantial changes be approved by the Legislature.”
The bill passed 3-2 and now goes to the floor for debate. Sen. Dennis Linthicum (R-Klamath Falls) said they may consider an minority report requiring Legislative approval of any changes.
HB 3428 – Moves PEBB into CCOs
The House Health Committee moved Rep. Julie Parrish’s bill to the House Rules Committee to keep it alive. The Rules Committee is not subject to chamber deadlines.
The bill would move Public Employee health coverage into CCOs in an effort to control the rising cost of public employee benefits.
SB 997 – Penalties for Employers if Employees are on OHP
Sen. Elizabeth Steiner Hayward’s (D-Portland) concept to pay for employed people on the Oregon Health Plan did not move out of committee this week. It is now dead.
HB 2300 – Mental Health Rx Parity in CCOs
This bill requires the cost of mental health drugs to be taken into account when determining the global budget of CCOs.
The committee passed the bill with an amendment that creates a 12-member mental health clinical advisory group in the Oregon Health Authority. It now goes to Ways and Means.
HB 3135 – Post-partum Contraceptive mandate
This bill requires Medicaid to cover intrauterine devices and progestin implants following labor and delivery.
There is an amendment that requires OHP to reimburse the cost of getting a device removed as well.
The committee passed the bill. It now goes to Ways and Means.
SB 808 – Screening Newborns
This bill requires that the Oregon Health Authority specify that a health testing service may conduct tests for newborns for conditions listed on the most recent edition of Recommended Uniform Screening Panel by United States Department of Health and Human Services. This includes a broader array of tests than traditionally done by testing services.
The committee passed the bill. It now goes to Ways and Means.
HB 2839 – Anatomical gifts for people with disabilities
The bill’s intended purpose is to prevent discrimination of disabled persons in consideration of an organ donation. This bill prohibits eye banks, tissue banks, procurement organizations and providers from considering any disability in the decision process of providing someone with an organ donation. The bill also prevents those entities from requiring an individual with a disability to demonstrate their ability to perform major life activity post-donation.
The committee adopted an amendment agreed upon by OHSU and Providence in collaboration with the other transplant centers.
The committee passed the bill. It now goes to the floor.
SB 785 – Antibiotics in Farm Animals
The bill that would have prohibited the use of antibiotics to food-producing animals except as recommended by a veterinarian to treat illness is dead.
SB 419 – Hospital Rate Commission amended as Taskforce
The committee adopted an amendment that replaces the bill with a taskforce to study the implementation of a Hospital Rate Commission. The original bill would have created a Hospital Rate Commission to review hospital charges and recommend to the OHA whether to approve those charges as reasonable based on prescribed criteria.
The committee passed the bill; it now goes to Ways and Means.
SB 1034 – Student loans tax-free
The Senate Education Committee approved a plan to make all student loan payments – principal and interest – tax-free.
“Other student debt reform proposals have concentrated on just one income bracket or offered minimal tax breaks on debt interest. Those ideas are all tricycles. This is a Harley Davidson,” bill sponsor Sen. Chuck Thomsen (R-Hood River) said. “This is student debt reform on steroids.”
The bill now goes to the Senate Finance Committee where they will calculate the potential impact on state revenues.
HB 2526 – Firearm safety & suicide prevention
This bill, to require OHA to develop a firearm safety and suicide prevention educational program, missed the deadline for action and is dead for this session. It was scheduled for a work session on the final day but the House Judiciary Committee did not take action on the bill.
SB 868 Þ SB 719 – Guns and Suicide
These bills would allow someone to seek an “extreme risk protection order” in court for an immediate family member they believe is a suicide risk or threat to others. If a judge grants the order, the person would have to surrender their guns and would be prohibited from buying a gun for one year.
Sen. Brian Boquist (R-Dalles) is an Army veteran whose stepson, a Navy veteran, killed himself last year. Boquist said, “We’re trying to provide the best course of action that will allow families a chance to help prevent their veterans and other family members from killing themselves.”
Kevin Starrett, Oregon Firearms Federation opposed the bill saying, “There is no due process in this bill until you are convicted.”
Keely Hopkins, NRA, said, the bill does “Nothing to deal with the underlying issues or mental health crisis they are going through.”
Senate Judiciary Committee chair Sen. Floyd Prozanski (D-Eugene) said he neglected to state that SB 868 was being carried over for a work session. So they had to gut and stuff the contents of SB 868 into SB 719.
SB 48 – Suicide CE
This bill was amended to no longer require continuing education for medical and other professionals on suicide prevention. Sarah Lochner, OHA, said, “It removes the mandate and makes it voluntary.”
The bill now requires OHA to work with licensing boards to offer continuing education on suicide prevention.
The Senate Human Services Committee approved the bill. It now goes to the floor for debate.
HB 2834 – CCO Effectiveness Study Þ Office Sedation Þ Dental benefits for Seniors and Veterans
This is one of those bills where you don’t want to watch the sausage being made.
Because the bill is “relating to health care” anything health care related can go into the bill.
It started out as a bill to study the effectiveness of CCOs. The only hearing on the bill dealt with Rep. Cedric Hayden’s (R-Cottage Grove) concern about the use of sedation in medical and dental offices. But the amendment passed by the House Health Committee has nothing to do with either of those issues.
Rep. Hayden came up with another proposal to provide free dental care to veterans and seniors with incomes below 250% of federal poverty (about $30,000 per year). No estimate was given for how many people this would cover or how much it would cost.
Rep. Alyssa Keny-Guyer (D-Portland) said, “I applaud your efforts and would like to add pregnant women to the bill.”
Rep. Hayden said he’d like to pay for the veterans with funding from Ballot Measure 96 and require CCOs to pay for the seniors’ benefit out of their incentive funds.
The committee unanimously approved sending the bill to Ways and Means.
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