HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

April 21, 2003 Hearing Room 50

3:15 PM Tapes  96 - 97

 

MEMBERS PRESENT:            Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

Rep. Alan Bates

 

MEMBERS EXCUSED:            Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

 

GUEST MEMBERS:               Rep. Monnes Anderson

 

STAFF PRESENT:                  Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:                     Work Session

                                                Possible Introduction of Committee Bill

 

These minutes are in compliance with Senate and House Rules.  Only text enclosed in quotation marks reports a speaker’s exact words.  For complete contents, please refer to the tapes.

 

TAPE/#

Speaker

Comments

TAPE 96, A

003

Chair Westlund

Calls meeting to order and opens the work session..

WORK SESSION

003

Rep. March

Moves LC Draft 3547 be introduced as a committee bill.

008

Chair Westlund

Asks if there is any discussion and goes over the changes that may occur on the draft they have in hand.

  • Section 6, Page 5, line 1
  • Section 9, Page 7, line 24 & 25

Extends a thank you to all that have participated to get us this far and states that this is still a work in progress.

048

Rep. Kruse

Would also like to mention Holly Robinson.

050

Rep. March

MOTION:  Moves LC 3547 BE INTRODUCED as a committee bill.

 

 

VOTE:  5-0

EXCUSED:  2 - Morgan, Miller

 

Chair

Hearing no objection, declares the motion CARRIED.

055

Chair Westlund

Also extends a thank you to the staff for their work and participation.

*******

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RECESS*************************************************

067

Chair Westlund

Calls Holly Robinson up for her testimony on the LC Draft 3547.

085

Holly Robinson

Introduces herself from Legislative Council and begins the description of the LC Draft 3547. (EXHIBIT A)

105

Chair Westlund

Would like to add that the bigger overarching policy discussion here is to get as many people as possible into Managed Care.

113

Robinson

Agrees that that is the overarching policy in sections 1 & 2.

105

Rep. Monnes Anderson

Asks is our fully capitated health plan CareOregon.

109

Rep. Kruse

Answers that there is fourteen of them.

114

Robinson

Continues presentation on Sections 4 &5 of the Draft.

139

Rep. Greenlick

Asks if there is a smaller number of those in Section 5 than in Section 14.

143

Chair Westlund

Comments that those are really two different issues, but at some level they are achieving the same thing and elaborates.

151

Robinson

Continues presentation in Section 6.

158

Rep. Greenlick

Asks if the Section 5 organization is not a fully capitated health plan.

160

Robinson

Responds that, that is correct.

162

Rep. Monnes Anderson

Asks for clarification on Section five.

166

Chair Westlund

Responds and gives clarification about how it works.

168

Rep. Anderson

Asks are there more than one that serve more than 2000.

170

Chair Westlund

Responds no.

172

Robinson

Continues presentation.

195

Rep. Kruse

Comments that the sections she is discussing will most likely have an extensive rewrite.

203

Robinson

Continues presentation.

213

Rep. Anderson

Asks if Section 8, Sub Section 3 is saying that different areas within the State will be receiving different capitation rates.

218

Robinson

Explains what Department of Human Services is doing with the five major regions.

230

Rep. Kruse

Gives a follow up for an example.

240

Chair Westlund

Comments that there are a lot of bells and whistles that have to come off of this bill or a companion to this bill, there still are a lot of issues to be determined.

250

Rep. Greenlick

Asks how Secretary of State got into this in naming an actuary instead of DAS.

256

Chair Westlund

Explains how this process worked.

275

Rep. Monnes Anderson

Trying to grasps what we have now and how this is different, and asks the reason our plans would want to form contracts with OMAP, is because an incentive for them would be because we don’t have hospital costs.

313

Chair Westlund

Explains that no, they already have contracts and this is very difficult and elaborates.

325

Rep. Kruse

Comments that Chair Westlund is describing right now is not reflected in this bill and will be part of the re-writes.

351

Robinson

Finishes her discussion of Section 9.

354

Chair Westlund

Comments that currently transportation costs are not included and in particular number 3 in prescription drugs accepting the anti-psychotic drugs and whether they are included or not.

362

Robinson

Continues on Section 10.

375

Chair Westlund

Comments that it is fair to say that at least long term, section 10 could go away if we can figure out a methodology of what I had described before, with projecting a costing and a cost differential that we can establish.

381

Robinson

Continues on through section eleven.

396

Chair Westlund

Comments this is how we go about getting pharmaceuticals at the lowest cost.

TAPE 97, A

007

Rep. Kruse

Comments that this section may also be up for revision.

015

Robinson

Continues presentation.

028

Rep. Kruse

Comments that section seventeen may also need to be written.

032

Rep. Greenlick

Asks how these three organizations fit into this and what is the relevance of the three of them in the Medicaid reform.

038

Robinson

Explains how these three different organization fit into this LC draft.

055

Rep. Greenlick

Does not see anything of substance in here except the fully capitated health plan and asks is there somewhere in here where there is some responsibility given to pre-paid Managed Care health services organizations and is there some where in here where there is some responsibility except to collect contributions for physician care organizations.

065

Robinson

Gives explanation of the part of the Oregon Revised Statutes that talks about this.

081

Rep. Greenlick

It looks like in section 2 we have everyone in a fully capitated health care system or in fee for service managed by a fully capitated health care system.

090

Robinson

Comments that the majority of the actors that are primarily effected at this point it is true that it would be fully capitated health plans and hospitals to some degree and elaborates.

111

Rep. Greenlick

Comments that then page 1 line 22 – 24 that provides everything in that larger bucket.

115

Chair Westlund

Comments that a lot of this revolves around capacity and elaborates.

123

Rep. Kruse

Comments that there are some outlying here, redefining access and moving in the direction we are wanting to go.

125

Rep. Monnes Anderson

Comments right now a person is eligible for Medicaid dollars for services rendered without being in a health plan, is this what we have now.

134

Robinson

Responds yes and give a more detailed explanation.

144

Rep. Monnes Anderson

So a person that shows up at the hospital door and is eligible for Medicaid or is not, this shows Managed Care does not pay for anything for hospitals at this point, because they don’t meet the criteria or a Managed Care plan won’t take them.

158

Robinson

Comments that this LC Draft does not address that issue and elaborates.

161

Chair Westlund

Comments that this is a delivery system model, we can do what we have all been talking about in here for so long, with the Federal minimums, if there is to be additional populations, that is a revenue question.

186

Rep. Anderson

Not sure which categories fully capitated health plan or pre paid managed health care an IPA would fit into, or would it fit into both.

190

Robinson

Comments it depends on the contact they have with the state and elaborates.

208

Chair Westlund

Asks if there is any more questions for Holly Robinson and reiterates that this is the frame work and is a work in progress.

217

Rep. March

Comments that this is the delivery system design that would allow us to cover the categorical Medicaid population with what we have been allotted to spend at this time.

235

Chair Westlund

Wants to make a real distinction that this is a deliver system model and while in its efficiencies it allows us to buy some benefits that we think are minimal benefits and does have revenue implications in that this is a more efficient delivery model and he would encourage everyone to think of this as a delivery system model and not a revenue producing vehicle although it does produce cost savings. 

265

Rep. Merkley

Comments wouldn’t this frame work that has been written provide a framework for anyone else that we make eligible.

267

Chair Westlund

Responds absolutely and explains in more detail.

275

Chair Westlund

Make announcements and calls meeting to a close and adjourns 4:46 pm.

 

 

EXHIBIT SUMMARY

 

A – LC Draft 3547, staff, 11 pp