HOUSE COMMITTEE ON HEALTH AND HUMAN SERVICES

 

May 28, 2003 Hearing Room D

9:00 AM Tape 115 – 116

 

MEMBERS PRESENT:            Rep. Jeff Kruse, Chair

Rep. Billy Dalto, Vice-Chair

Rep. Carolyn Tomei, Vice-Chair

Rep. Gordon Anderson

Rep. Jeff Barker

Rep. Laurie Monnes Anderson

 

MEMBER EXCUSED:             Rep. Ben Westlund

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

Mara McGraw, Committee Assistant

 

MEASURE/ISSUES HEARD:            HB 2859 – Work Session

                                                HB 2189 – Work Session

                                                HB 2537 – Work Session

                                                HB 2308 – Work Session

                                                Informational Meeting – Automating the Coordination of Benefits:

Adam Grad, Director, National Accounts, Digital Healthcare, Inc.

                                                SB 646A – Public Hearing and Work Session

                                                SB 647A – Public Hearing and Work Session

 

 

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 115, A

003

Chair Kruse

Calls meeting to order at 9:15 a.m. and announces schedule for afternoon session. Opens work session on HB 2859.

HB 2859 – WORK SESSION

020

Rep. Tomei

MOTION:  Moves HB 2859 to the floor WITHOUT RECOMMENDATION as to passage and BE REFERRED to the committee on Rules and Public Affairs.

025

 

VOTE:  5-0

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

EXCUSED:  2 - Dalto, Westlund

 

Chair Kruse

The motion CARRIES.

027

Chair Kruse

Closes work session on HB 2859, and opens work session on HB 2189.

HB 2189 – WORK SESSION

030

Sandy Thiele-Cirka

Committee Administrator. Summarizes HB 2189 and the proposed -1 amendments (EXHIBIT A).

040

Chair Kruse

Clarifies with Mr. King that the -1 amendments address the problems with the bill as originally written.

045

Rocky King

Administrator, Insurance Pool Governing Board (IPGB). Indicates his support for the bill as amended with the -1 amendments.

050

Rep. Barker

MOTION:  Moves to ADOPT HB 2189-1 amendments dated 05/28/03.

 

 

VOTE:  6-0

EXCUSED:  1 - Westlund

 

Chair Kruse

Hearing no objection, declares the motion CARRIED.

052

Thiele-Cirka

Points out the bill has a subsequent referral to the Committee on Ways and Means.

055

Rep. Barker

MOTION:  Moves HB 2189 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

060

 

VOTE:  6-0

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

EXCUSED:  1 - Westlund

 

Chair Kruse

The motion CARRIES.

061

Chair Kruse

Closes work session on HB 2189 and opens work session on HB 2537.

HB 2537 – WORK SESSION

065

Thiele-Cirka

Offers a description of HB 2537, and introduces the proposed -2 amendments (EXHIBIT B). Submits to the record an informational packet (EXHIBIT C) on behalf of Michael Morter of the Department of Consumer and Business Services, Insurance Division.

075

Chair Kruse

States intent regarding the proposed amendments.

078

Rep. Tomei

MOTION:  Moves to ADOPT HB 2537-2 amendments dated 03/20/03.

080

Rep. Monnes Anderson

Points out other interested parties are negotiating possible amendments.

085

J. L. Wilson

National Federation of Independent Business (NFIB/Oregon). Indicates his intent for the compromise to be completed on Senate side.

100

Rep. Anderson

Clarifies the Chair’s preference for action on the bill.

105

Chair Kruse

Explains his preference that the bill be passed out without amendments to be further worked on the Senate side.

110

 

VOTE:  1-5

AYE:               1 - Tomei

NAY:               5 - Anderson, Barker, Dalto, Monnes Anderson, Kruse

EXCUSED:     1 - Westlund

 

Chair Kruse

The motion FAILS.

115

Rep. Tomei

MOTION:  Moves HB 2537 to the floor with a DO PASS recommendation.

120

Rep. Tomei

Expresses concern for possible unintended consequences upon passage of the bill. Indicates her intention to vote No on the motion.

130

Rep. Anderson

Indicates his intent to vote Aye on the motion, and comments on the high costs of health care.

140

Rep. Monnes Anderson

Comments on balance between basic health care and small business interest.

150

Chair Kruse

Declares conflict of interest as a small business owner.

155

 

VOTE:  5-1

AYE:               5 - Anderson, Barker, Dalto, Monnes Anderson, Kruse

NAY:               1 - Tomei

EXCUSED:     1 - Westlund

 

Chair Kruse

The motion CARRIES.

CHAIR KRUSE will lead discussion on the floor.

160

Chair Kruse

Closes work session on HB 2537, and opens work session on HB 2308.

HB 2308 – WORK SESSION

165

Thiele-Cirka

Offers a description of HB 2308 and the proposed -2 amendments (EXHIBIT D).

175

Bruce Bishop

Oregon Association of Hospitals and Health Systems. Submits written testimony in support of the -2 amendments (EXHIBIT E). Presents history of bill and the proposed -2 amendments.

205

Rep. Monnes Anderson

Inquires if when a patients requests their records, would they be required to pay the fee.

210

Bishop

Notes provider has authority to waive fee.

215

Rep. Monnes Anderson

Inquires on Washington State’s similar legislation and Oregon Health Sciences University (OHSU) fees.

220

Bishop

Discusses Washington State law and fee structure.

230

Rep. Monnes Anderson

Asks why the term “reasonable fee” could not be used in place of specific pricing.

235

Bishop

Recalls that the original bill did not specify a fee, but the Senate committee felt a fee should be specified in statute.

245

Rep. Monnes Anderson

Asks that the representative for the OHSU could address this issue. Notes she disagrees with the Senate on this issue.

260

Bishop

Agrees with Rep. Monnes Anderson and further explains the changes made on the Senate side.

275

Jeff Gilmore

OHSU. Discusses the rates as defined in statute.

295

Rep. Monnes Anderson

Asks whether the Governor’s office has any input on the issue.

300

Gilmore

Recommends that Ms. Dayton of the Oregon Association of Hospitals address the issue.

305

Gwen Dayton

General Counsel, Oregon Association of Hospitals. Discusses current fees for record copies as they relates to OHSU.

330

Chair Kruse

Points out that the fees in the bill are caps.

340

Dayton

Further comments on the fee cap and whether OHSU reaches that cap.

350

Chair Kruse

Comments on the Senates amendment on the bill.

335

Rep. Monnes Anderson

Requests Governors office input.

365

Erinn Kelley-Siel

Health Senior Policy Analyst, Governor's Office. Discusses constituent input on fee schedule. Notes OHSU has adopted the suggested fee structure.

415

Rep. Monnes Anderson

Clarifies the fee is a cap.

420

Chair Kruse

Presents history on bill.

435

Rep. Anderson

Compares fees between hospitals and private sector.

450

Dayton

Details range of fees in copy charges. Notes fee schedule was adopted as Senate requirement. Notes additional labor required with medical records due to HIPAA.

TAPE 116, A

010

Chair Kruse

Clarifies Rep. Monnes Anderson’s intent.

015

Dayton

Comments on the cost regarding copying records.

020

Rep. Tomei

Discusses cost for each page.

030

Dayton

Reiterates HIPAA requirements of basic analysis of each page no matter the number of pages included.

040

Rep. Monnes Anderson

Discusses practitioner role in record copy process as it relates to fee structure. Reports understanding need for fee structure.

055

Rep. Dalto

Inquires on process to reproduce records as it relates to labor cost.

060

Dayton

Discusses range of staffing needs in a records department.

065

Rep. Anderson

Comments on HIPAA regulations.

075

Chair Kruse

Inquires on potential conceptual amendments.

080

Dayton

Discusses the goals for the bill as they relate to HIPAA.

100

Chair Kruse

Clarifies his intent regarding the bill.       

110

Rep. Anderson

MOTION:  Moves to ADOPT HB 2308-2 amendments dated 05/23/03.

 

 

VOTE:  6-0

EXCUSED:  1 - Westlund

 

Chair Kruse

Hearing no objection, declares the motion CARRIED.

115

Rep. Anderson

MOTION:  Moves HB 2308 to the floor with a DO PASS AS AMENDED recommendation.

120

 

VOTE:  6-0

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

EXCUSED:  1 - Westlund

 

Chair Kruse

The motion CARRIES.

125

Rep. Tomei

MOTION:  Moves HB 2308 be placed on the CONSENT CALENDAR.

 

 

VOTE:  6-0

EXCUSED:  1 - Westlund

 

Chair Kruse

Hearing no objection, declares the motion CARRIED.

130

Chair Kruse

Closes the work session on HB 2308, and opens an informational meeting.

INFORMATIONAL MEETING

135

Adam Grad

Digital Health Care. Submits informational packet (EXHIBIT F). Discusses changes in HIPAA laws as they related to preemptive coordination of benefits and to cost avoidance and correct payment of services. Presents PowerPoint presentation on digital health care.

295

Rep. Anderson

Inquires on patient claims process.

300

Grad

Explains claims as they relate to primary insurance coverage. Continues presentation on digital health care.

TAPE 115, B

001

Grad

Continues with informational presentation on digital health care.

050

Rep. Monnes Anderson

Inquires on identification of patient with regard to similarity or difference in names.

055

Grad

Explains three criteria for identification of patient: name, address, and date of birth.

080

Rep. Monnes Anderson

Inquires on confidentiality as it relates to technology.

085

Grad

Explains information is obtained through a direct hard line to private server and is not available on internet or to general public.

095

Rep. Tomei

Inquires on current use of program.

100

Grad

Explains availability is subject to HIPAA and currently underway.

120

Rep. Dalto

Inquires on organization headquarters location.

125

Grad

Submits that his company’s headquartered in Cleveland, Ohio. Continues presentation on digital health care. Discusses computer technology used in operation of program. Details process for adopting program.

150

Rep. Tomei

Inquires on fees for service.

152

Grad

Provides figures. Presents cost savings projections for Oregon.

185

Chair Kruse

Offers history of issue and choice to provide presentation. Discusses advantages of outsourcing service. Notes Senate bill in process which addresses the issue.

200

Rep. Tomei

Inquires on organization expenses and profits.

205

Rep. Anderson

Inquires on timeline.

210

Chair Kruse

Details process and timeline to adopt program.

220

Rep. Anderson

Inquires on funding.

225

Chair Kruse

Comments on funding, and notes cost savings.

230

Grad

Discusses recovery fees discussed in informational packet.

240

Rep. Barker

Notes potential annual cost.

245

Grad

Points out figures are retrieved from Oregon Medicaid data.

260

Chair Kruse

Notes bill has a subsequent referral to Ways and Means.

265

Rep. Monnes Anderson

Inquires about actual savings for the state.

270

Grad

Discusses guarantees incentives to adopt program.

295

Chair Kruse

Closes the informational meeting and recesses the meeting at 10:30 a.m., until the Committee reconvenes at 1:30 p.m.

RECESS

300

Chair Kruse

Reconvenes meeting at 1:45 P.M. and opens public hearings on SB 646A and SB 647A as a subcommittee.

SB 646A & SB 647A – PUBLIC HEARING

320

Marshall Coba

Oregon Society of Physician Assistance. Submits written testimony in support of SB 646A and SB 647A (EXHIBIT G).

365

Chair Kruse

Reopens the meeting as a full committee.

370

Pat Kenney-Moore

President Elect, Oregon Society of Physician Assistance. Offers testimony in support of SB 647 A, and speaks to improved patient care.

445

Chair Kruse

Closes the public hearings on SB 646A and SB 647A and opens a work session on SB 646A.

SB 646A – WORK SESSION

455

Rep. Monnes Anderson

MOTION:  Moves SB 646A to the floor with a DO PASS recommendation.

460

 

VOTE:  4-0

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

EXCUSED:  3 - Anderson, Barker, Westlund

 

Chair Kruse

The motion CARRIES.

465

Rep. Tomei

MOTION:  Moves SB 646A be placed on the CONSENT CALENDAR.

 

 

VOTE:  4-0

EXCUSED:  3 - Anderson, Barker, Westlund

 

Chair Kruse

Hearing no objection, declares the motion CARRIED.

470

Chair Kruse

Closes work session on SB 646A and opens work session on SB 647A.

SB 647A – WORK SESSION

475

Rep. Monnes Anderson

MOTION:  Moves SB 647A to the floor with a DO PASS recommendation.

480

 

VOTE:  4-0

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

EXCUSED:  3 - Anderson, Barker, Westlund

 

Chair Kruse

The motion CARRIES.

485

Rep. Tomei

MOTION:  Moves SB 647A be placed on the CONSENT CALENDAR.

 

 

VOTE:  4-0

EXCUSED:  3 - Anderson, Barker, Westlund

 

Chair Kruse

Hearing no objection, declares the motion CARRIED.

490

Chair Kruse

Closes work session on SB 647A and adjourns meeting at 1:50 p.m.

 

 

EXHIBIT SUMMARY

 

A – HB 2189, -1 amendments, Staff, 5 pp.

B – HB 2537, -2 amendments, Staff, 1 pp.

C – HB 2537, submitted written testimony from Michael Morter, Staff, 23 pp.

D – HB 2308, -2 amendments, Staff, 2 pp.

E – HB 2308, written testimony, Bruce Bishop, 1 p.

F – Informational, written testimony, Adam Grad, 53 pp.

G – SB 646A, written testimony, Marshall Coba, 12 pp.