HOUSE COMMITTEE ON

AUDIT & HUMAN SERVICES BUDGET REFORM

 

May 1, 2003 Hearing Room 50

3:15 PM Tapes105 - 106

 

MEMBERS PRESENT:††††††††††† Rep. Ben Westlund, Chair

Rep. Steve March, Vice-Chair

Rep. Jeff Kruse

Rep. Jeff Merkley

 

MEMBERS EXCUSED:††††††††††† Rep. Randy Miller

Rep. Susan Morgan, Vice-Chair

Rep. Alan Bates

 

GUEST MEMBERS:†† ††††††††††† Rep. Mitch Greenlick

 

STAFF PRESENT:††††† ††††††††††† Rick Berkobien, Committee Administrator

Kelly Fuller, Committee Assistant

 

ISSUES HEARD:†††††††† ††††††††††† Informational Meeting Ė HB 3624

††††††††††††††††††††††† ††††††††††† ††††††††††† Invited Testimony

††††††††††††††††††††††† ††††††††††† ††††††††††† Barney Speight, Kaiser Permanente

††††††††††††††††††††††† ††††††††††††††††††††††† ††† Discussion on possible changes to HB 3624

††††††††††††††††††††††† ††††††††††† ††††††††††† Scott Gallant, Oregon Medical Association

††††††††††††††††††††††† ††††††††††††††††††††††† ††† Medical liability in the medical practice environment

††††††††††††††††††††††† ††††††††††† ††††††††††† Kevin Earls, Oregon Association of Hospitals and Health Systems

††††††††††††††††††††††† ††††††††††††††††††††††† †† OHP reimbursement policies, the cost to other purchasers

 

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

 

TAPE/#

Speaker

Comments

TAPE 105, A

003

Chair Westlund

Calls the meeting to order and opens the informational meeting on HB 3624.

INVITED TESTIMONY

040

Barney Speight

Kaiser Permanente, his purpose today is to discuss the possible changes to the HB 3624.Begins testimony with section one of the bill.

116

Chair Westlund

Asks if he would please talk about the conflicting statutory requirements that we will reimburse at full costs, at a reasonable cost.

121

Speight

Would like to defer that until he gets to section eight.Continues with section two.

395

Rep. Greenlick

Comments that one of the difficulties in continuing to fund health care has been changes in proportionality one segment growing faster than another segment.The proportionality seems to reward that.

TAPE 106, A

007

Speight

Comments that this is something that we are looking deeply into and elaborates.

021

Rep. Greenlick

As he was talking, he was thinking about the QEM and one of the original portions of the Oregon Health Plan (OHP), it seems to me that that does not do that anymore and elaborates.

044

Speight

Would concur that it does move it into many different directions, and elaborates.

078

Chair Westlund

Would site what I think is a significant difference between the QEM model and what we are discussing, that the yard stick, the measurement of how you gauge how well you are funding are outside objective measurements they are not self generated from within a group of advocates and elaborates.

087

Rep. Greenlick

Asks which one was the independent outside.

091

Chair Westlund

Responds that it is Medicare, that is what the rates would be based on.

093

Rep. Greenlick

Asks if it is the Medicare rates per services rendered.

095

Chair Westlund

Respond yes, RVU, DRG, etc.

097

Rep. Greenlick

Comments that the utilization pattern is not independent.

098

Speight

Adds to the conversation above.

113

Rep. March

One of the dangers in this yard stick is that we are getting to the point of this being on someone elseís turf and I donít want to lock them into a yard stick.

123

Speight

Responds to the questions on the dangers of this yard stick, and continues with section fourteen.

173

Rep. Greenlick

Would like to discussion section ten and asks if it would that prohibit hospitals from servicing those clients.

186

Speight

Would like not to go into section ten right now, but he knows all hospitals are required under law to treat emergency patients.

197

Rep. Greenlick

Makes comments regarding transplants services, that it may be more difficult.

199

Chair Westlund

Comments that part of that gets into the primary care position and elaborates.

210

Scott Gallant

Oregon Medical Association, presents testimony (EXHIBIT A & B) and begins presentation.

299

Rep. Greenlick

Asks question on page threeís chart.

313

Gallant

Gives an explanation of his charts.

TAPE 105, B

055

Rep. Greenlick

Comments that he has talked with some Lawyers who talk about their own liability coverage and their community rating among lawyers their malpractice coverage and wondering why physicians insist on an experience rating, rating by class rather than by community rating among all physicians, could you touch on that a little bit.

063

Gallant

Comments that the Attorney professional liability fund has a limit that we would love to have and elaborates.

081

Rep. Greenlick

Asks is there any possibility of pooling those rates.

087

Gallant

Responds to the question on pooling rates.

090

Rep. Greenlick

Comments that the assumption is that you canít practice is you donít have backup and elaborates.

097

Gallant

Comments that in order to do the PLF model which is based on all attorneys would be paying the same rate regardless of their type of practice and elaborates.Comments on what the other fundamental issue is which is you are expending greater amounts of money than you are getting from the physicians.

153

Rep. Greenlick

Makes additional comments about the issue they are discussing.

165

Gallant

Continues presentation on page seven of (EXHIBIT B).

197

Rep. Greenlick

Asks a question on page seven about he percentages.

200

Gallant

Gives an explanation of the percentages in questions.

214

Rep. Greenlick

Doesnít this chart say that only forty percent accepted it in 2002, but eighty percent accepted it in 2003.

219

Gallant

Gives details of this chart and what itís purpose is.

244

Rep. Kruse

Comments that this looks like the same time frame it would take to get into his doctor.

248

Gallant

Comments that it is very difficult and states what his point is.

255

Rep. March

Questions the one and five physicians that do not current accept Oregon Health Plan on page seven, are they the same physicians that do not accept workersí compensation because of the paperwork.

268

Gallant

Gives an explanation of those that do not accept this and why.

394

Rep. March

Asks what is percentage of the doctors that donít take OHP and also donít take Workersí Compensation.

399

Gallant

Comments that he does not have that information and continues presentation.

350

Rep. Greenlick

Asks what he makes of the quote on the last page.

355

Gallant

Comments that it is not as much fun and that is where it comes from.Most physicians will tell you that they enjoy their patients and they hate the environment that they are in.

435

Chair Westlund

Calls meeting to a close and adjourns 5:06 pm.

 

 

EXHIBIT SUMMARY

 

A Ė Informational, prepared testimony, Scott Gallant, 19 pp

B Ė Informational, prepared testimony, Scott Gallant, 20 pp