HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

March 14, 2003   Hearing Room D

9:00 A.M. Tapes 51 – 52

 

MEMBERS PRESENT:            Rep. Jeff Kruse, Chair

Rep. Billy Dalto, Vice-Chair

Rep. Carolyn Tomei, Vice-Chair

Rep. Gordon Anderson

Rep. Ben Westlund

 

MEMBER EXCUSED:             Rep. Jeff Barker

Rep. Laurie Monnes Anderson

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

Mara McGraw, Committee Assistant

 

MEASURES HEARD:                     HJM 4 – Public Hearing and Work Session

                                                HB 2374 – Public Hearing

                                                HB 2558 – Public Hearing

                                                HB 2642 – Public Hearing

 

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 51, A

005

Chair Kruse

Calls meeting to order at 9:04 A.M. and announces HB 2684 will be postponed until March 17, 2003. Opens public hearing on HJM 4.

HJM 4 – PUBLIC HEARING

008

Sandy Thiele-Cirka

Administrator. Summarizes bill.

014

Jim Gardner

Pharmaceutical Manufacturers of America (PhRMA). Addresses impact of bill on moving issue forward in Congress.

026

Chair Kruse

Closes public hearing on HJM 4 and opens work session on HJM 4.

HJM 4 – WORK SESSION

030

Rep. Anderson

MOTION:  Moves HJM 4 be sent to the floor with a BE ADOPTED recommendation.

031

Rep. Anderson

Addresses need for federal assistance.

036

Chair Kruse

Notes history of bill.

040

Rep. Tomei

Inquires if other states have passed similar memorials.

045

 

VOTE:          5-0-2

AYE:            In a roll call vote, all members present vote AYE.

EXCUSED:  2 – Barker, Monnes Anderson

049

Chair Kruse

The motion CARRIES.

REP. KRUSE will lead discussion on the floor.

056

Chair Kruse

Closes work session on HJM 4 and opens public hearing on HB 2374.

HB 2374 – PUBLIC HEARING

058

Thiele-Cirka

Summarizes bill and -1 amendment (EXHIBIT A).

068

Bruce Carlson M.D.

Pharmacists. Submits written testimony in support of HB 2374 (EXHIBIT B). Addresses impact on rural health providers and rural communities. Speaks to fiscal impact. Suggests language for amendment.

115

Rep. Anderson

Inquires on formula.

118

Carlson

Reports formula involves 20 medications.

121

Rep. Tomei

Inquires on legend drugs.

123

Carlson

Defines legend drugs.

128

Rep. Tomei

Clarifies any drug requiring a prescription is a legend drug.

129

Carlson

Concurs.

137

Lynn Read

Office of Medical Assistance Programs (OMAP), Department of Human Services (DHS). Submits written testimony in support of bill (EXHIBIT C). Notes current options for rural health clinics to dispense drugs. Addresses issues of administering the programs and billing the claims. Speaks to efforts in rural health access.

193

Rep. Westlund

Notes efforts of workgroup on Oregon Health Plan (OHP).

213

Peggy Anet

Health Insurance Association of America (HIAA). Submits testimony in opposition to bill (EXHIBIT D). Discusses concerns with mandatory reimbursement requirements. Reports on current statue in regard to required analysis. Notes table on insurance mandates (EXHIBIT D-page 4). Discusses process and technical concerns relating to the insurance code.

310

Tom Holt

Oregon State Pharmacists Association. Testifies in support of HB 2374. Notes support relates to small number of pre-packaged drugs and appropriate dispensing technology.

341

Rep. Anderson

Inquires on physicians dispensing license.

344

Holt

Explains license is approved through board of medical examiners.

357

Karen Whitaker

Director, Office of Rural Health, Oregon Health and Sciences University (OHSU). Submits written testimony in support of bill (EXHIBIT E). Lists other supporting parties. Notes rural areas that qualify under bill (EXHIBIT E-page 6).

402

Ed Patterson

Oregon Rural Health Organization. Submits written testimony from Carlson. Notes lack of additional cost to insurers. Urges adoption of -1 amendment.

426

Rep. Westlund

Inquires on result of excluding private insurance from bill

429

Patterson

Concurs suggestion as an option.

434

Chair Kruse

Addresses passing incomplete bills Senate. Requests interested parties meet and address concerns. Closes public hearing on HB 2374 and opens public hearing on HB 2558.

TAPE 52, A

HB 2558 – PUBLIC HEARING

024

Thiele-Cirka

Summarizes bill.

034

Gardener

Submits written testimony in support of HB 2558 (EXHIBIT F). Addresses preemptive preclusion by Drug Use Review (DUR) Board of drugs used to treat new conditions not yet assigned to the priority list.

077

Rep. Tomei

Inquires on history of bill.

080

Gardner

Defers to next witness.

082

Don Stecher

Representing Novartis Pharmaceuticals. Presents history of the drug.

109

Rep. Tomei

Inquires if Oregon DUR Board has decided if the drug is appropriate.

111

Stecher

Reports decision on drug has not been made. Reports that Oregon is only state that does not cover drug for Medicaid patients.

114

Rep. Tomei

Clarifies drug status by Oregon DUR Board.

121

Stecher

States drug is not covered by Oregon Health Plan (OHP).

124

Gardner

Explains bill addresses a procedural process to cease pre-emptive action on drugs and will not effect specific drugs.

137

Rep. Tomei

Inquires what precipitated decision.

142

Stecher

Explains other drugs under same policy.

149

Rep. Tomei

Inquires why policy was enacted.

150

Gardner

Explains condition drug treats and status on OHP prioritization list. States the condition is now treatable.

162

Rep. Tomei

Explains attempt to understand DUR Board decision.

173

Rep. Alan Bates

House District 5. Comments on treatment and OHP priority list.

196

Gardner

Explains treatment of conditions below the cut off for OHP priority list.

205

Paul Nielson

Representing Pharmacia. Details other drugs with history of similar restrictions. Requests allowing the drug to come to market before placing Medicaid coverage restrictions.

229

Holt

Testifies in opposition to bill. Clarifies role of DUR Board in relation to OMAP. Notes drugs grandfathered into policy. Urges committee not to restrict DUR Board.

287

Chair Kruse

Comments on advisory nature of DUR Board. Notes issue is matter of process. Explains committee will invite DUR Board to committee to address questions. Closes public hearing on HB2558 and opens public hearing on 2642.

HB 2642 – PUBLIC HEARING

312

Thiele-Cirka

Summarizes bill.

327

Jim Anderson

American College of Emergency Physicians, Oregon Chapter. Offers history of bill.

340

David Toovy M.D.

Emergency Physician. Submits written testimony in support of bill (EXHIBI G). Relates patient stories relating to the bill. Lists corporations that have enacted similar policy. Notes lack of opposition over last six years as basis to remove the sunset.

TAPE 51, B

017

Nan Heim

Oregon State Ambulance Association. Testifies in support of bill. Requests amendment to include ambulance services.

039

Shawn Baird

Emergency Medical Technician (EMT) and President, Oregon State Ambulance Association. Submits written testimony in support of bill (EXHIBIT H). Explains role of EMT in diagnosis and treatment. Requests amendment language to formally recognize EMT’s as essential service.

070

Alan Bates, M.D.

Physician, Bend, Oregon. Testifies in support of HB 2642. Addresses abuses and misuses of emergency care. Notes patients often do not understand when to seek care and should not base decision on the expense.

119

Rep. Anderson

Inquires on instances in which payments should be refused.

123

Rep. Bates

Explains claims can still be rejected if deemed inappropriate. Explains some patients do not have access to or do not have a primary care physician. Notes Emergency Room physician needs ability to assess patient before deeming the case a non-emergency.

150

Anet

Notes concern relating to the sunset review policy. Notes tendency of policies to expand with each review. Requests language to clarify review process. Speaks to differences between ambulance and emergency room services.

195

Rep. Tomei

Comments that the testimony does not address abuses of rule.

197

Anet

Notes subjective nature of assessing severe pain and perception of what constitutes an emergency. Addresses gray area in accessing emergency services. Notes bill is companion to patient protection legislation from 1997. 

240

Chair Kruse

Closes public hearing on HB 2642 and adjourns meeting at 10:33 A.M.

 

EXHIBIT SUMMARY

 

A – HB 2374, -1 amendment, staff, 1 p.

B – HB 2374, written testimony, Bruce Carlson, 1 p.

C – HB 2374, written testimony, Lynn Read, 2 pp.

D – HB 2374, written testimony, Peggy Anet, 4 pp.

E – HB 2374, written testimony, Karen Whitaker, 6 pp.

F – HB 2558, written testimony, James Gardner, 2 pp.

G – HB 2642, written testimony, David Toovy, 2 pp.

H – HB 2642, written testimony, Shawn Baird, 1 p.