HOUSE COMMITTEE ON

HEALTH AND HUMAN SERVICES

 

June 23, 2003 Hearing Room D

9:30 A.M. Tapes 117 - 118

 

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

Rep. Ben Westlund

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

David Peffley, Committee Assistant

 

MEASURES HEARD:                     HB 3515 – Work Session

                                                HB 2511 – Work Session

                                                HB 2742 – 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 117, A

003

Chair Kruse

Calls the meeting to order at 9:37 a.m. and opens a work session on          HB 3515.

HB 3515 – WORK SESSION

008

Sandy Thiele-Cirka

Administrator. Summarizes HB 3515 and the -2 amendments (EXHIBIT A).  Notes the bill is required to move to Ways and Means.

020

Chair Kruse

Points out Digital Healthcare Inc. presentation and the relationship to the bill. Reminds the committee that HB 3515 will allow collections to occur on the front end filing claims.

035

Rep. Monnes Anderson

Questions the contents of HB 3515 and whether Oregon will be the first state to enact this type of legislation.

029

Chair Kruse

Replies that Oregon would be one of the first, but not the only state to address this issue.

044

Rep. Tomei

Requests clarification on the implementation process.

048

Chair Kruse

Addresses the preferred timeline for setting the program in motion.

053

Rep. Anderson

Recalls that two or three states that are currently interested in the same type of program.

055

Chair Kruse

Reaffirms that other states, including Idaho are investigating this type of program.

058

Rep. Monnes Anderson

Questions fiscal impact.

059

Chair Kruse

States the bill needs to be referred to Ways and Means.

063

Rep. Westlund

MOTION:  Moves to ADOPT HB  3515-2 amendments dated 5/28/03.

065

 

VOTE:        7-0

066

Chair Kruse

Hearing no objection, declares the motion CARRIED.

070

Rep. Westlund 

MOTION:  Moves HB  3515 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means.

073

Rep. Monnes Anderson

Asserts support for the intent of HB 3515. Expresses concern for the bill’s fiscal impact, but adds that the incentives make for viable legislation.

088

 

VOTE:         7-0

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

089

Chair Kruse

The motion CARRIES.

090

Chair Kruse

Closes the work session on HB 3515 and opens a work session on           HB 2511.

HB 2511 – WORK SESSION

097

Thiele-Cirka

Summarizes HB 2511 and the -2 amendments (EXHIBIT B).

106

Holly Robinson

Deputy Legislative Counsel, Legislative Counsel. Addresses HB 2511 and begins section by section analysis and changes contained in the -2 amendments. 

133

Rep. Monnes Anderson

Questions the defining rules for specificity treatment relating to outpatient hospital services.

145

Robinson

Notes that the rules are in place and adds that the level of services should not change as a result of HB 2511. Continues explanation of the -2 amendments, addressing Subsections 1 and 4.

220

Rep. Monnes Anderson

Asks about benefits packages and the intent of the bill.

227

Robinson

Addresses the big picture in relationship to the bill. Discusses the differences between HB 2511 and SB 540.

262

Chair Kruse

Refers to the decision matrix in the Ways and Means committee.

264

Robinson

Completes comparison between HB 2511 and SB 540.

296

Rep. Anderson

Questions if current funding will maintain the program through the 2003-05 biennium.

308

Robinson

Replies that it is difficult to predict how long the revenue will last.  Notes that as a policy decision, funding has been addressed in the bill.

324

Rep. Anderson

States that he supports finding stable financing for a large number of people.

334

Chair Kruse

Refers to the decision matrix in the Senate committee. Details the figures agreed on as part of the Family Health Insurance Assistance Program (FHIAP).

376

Bruce Bishop

Oregon Association of Hospitals and Health Systems. Submits written testimony (EXHIBIT C) and opposes the -2 amendments. Details concerns with Section 2.

420

Chair Kruse

Explains that the intention of Section 2 is to define who is providing the services.

423

Bishop

Gives his interpretation of the definition of a primary care provider.

TAPE 118, A

012

Chair Kruse

Gives a contrary interpretation of what constitutes a primary care provider.

015

Bishop

Acknowledges an understanding of the drafters’ intent, but questions whether the language in the bill properly expresses that intent and is intelligible to the average reader of the statute. Continues review of concerns regarding Section 3.

052

Chair Kruse

Asks Robinson about a provision contained in Section 9.

056

Robinson

States uncertainty. Explains the genesis of Section 9.

063

Jim Edge

Director, Office of Medical Assistance Programs (OMAP). Notes that he doesn’t have a complete answer. Addresses the dual eligible, Medicare and Medicaid recipients.

070

Chair Kruse

Asks why coverage would kick in at the 75% threshold and not below.

074

Elizabeth Lopez

Administrator, Office of Employment and Financial Benefits, Department of Human Services. Addresses the eligibility for the dual benefits group vis-à-vis regular Medicare participants in explaining the rationale for the aforementioned threshold.

086

Bishop

Notes that he is not advocating for a position, but merely raising questions for consideration. Adds that those in the families’ category cap their eligibility at 75 percent of the poverty level.

098

Chair Kruse

Notes that the cap was instituted for those who are eligible for Temporary Assistance to Needy Families (TANF) or FHIAP.

104

Bishop

Continues review of concerns, addresses Section 4, especially Subsection 7. Asserts that this section is the heart of the Oregon Health Plan (OHP) and details that amending this section could possibly  reduce benefits and make other changes which would not be amenable to the continuance of OHP.  

198

Chair Kruse

Clarifies the purpose of Section 7 in giving Ways and Means the ability to add increase or reduce benefits. Emphasizes that the intention is to give Ways and Means flexibility.

222

Rep. Tomei

Expresses concern about the elimination of the OHP. Questions if the bill can be held for additional discussions.

229

Chair Kruse

States that he intends to move the bill to Ways and Means today.  Recommends that the bill be worked further in Ways and Means.  Reasserts that he sees nothing to indicate that this legislation might lead to the demise of OHP.

251

Rep. Tomei.

States that she would like to forward Bishop’s concerns to Ways and Means along with the bill.

255

Chair Kruse

Acknowledges request.

256

Rep. Tomei

MOTION:  Moves to ADOPT HB  2511-2 amendments dated 6/20/03.

257

Rep. Monnes Anderson

Announces that she will vote nay. Notes concerns relating to the impact on hospitals.

262

 

VOTE:            6-1

AYE:               6 - Anderson, Barker, Dalto, Tomei, Westlund, Kruse

NAY:               1 - Monnes Anderson

264

Chair Kruse

The motion CARRIES.

266

Rep. Tomei

MOTION:  Moves HB  3515 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

275

Rep. Tomei

VOTE:            6-1

AYE:               6 - Anderson, Barker, Dalto, Tomei, Westlund, Kruse

NAY:               1 - Monnes Anderson

270

Chair Kruse

The motion CARRIES.

287

Chair Kruse

Announces that Bruce Bishop’s concerns will be forwarded to the committee on Ways and Means.  Closes the work session on HB 2511 and opens a work session on HB 2742.

HB 2742 – WORK SESSION

295

Thiele-Cirka

Summarizes HB 2742 and the -2 amendments (EXHIBIT D).

308

Rep. Alan Bates

House District 5, Ashland. Discusses the intentions of HB 2742. States that the bill directs Secretary of State’s office to conduct an audit of Medicaid prescription drug manager (PDM). Points out that this would be the only program of its kind in the United States. Asserts that the cost of the audit is a wise investment.

362

Rep. Dalto

Questions the consequences of a hypothetical case of an audit discovering significant errors.

368

Rep. Bates

Replies that if errors are uncovered, the money would be refunded to Oregon’s Medicaid program and to the federal government, due to the 60-40 match.

377

Chair Kruse

Further clarifies the term errors. States that it does not denote an ineptitude but an oversight.

391

Rep. Bates

Concurs with Chair Kruse and comments on the complexities of the commercial market.

413

Rep. Westlund

Responds to Rep. Dalto’s query regarding errors. Asserts that HB 2742 is prudent and should save the state a great deal more than that.

TAPE 117, B

004

Rep. Monnes Anderson

Questions the fiscal impact of the bill.

007

Rep. Bates

Replies that the initial audit would cost approximately $75,000 with the federal government matching that amount.

021

Rep. Monnes Anderson

Asks if Legislative Fiscal Office (LFO) has addressed the bill.

024

Rep. Bates

Replies that LFO has been an active participant in bringing HB 2742 forward.

027

Rep. Barker

MOTION:  Moves to ADOPT HB 2742-2 amendments dated 6/20/03.

028

 

VOTE:  7-0

029

Chair Kruse

Hearing no objection, declares the motion CARRIED.

030

Rep. Westlund

MOTION:  Moves HB 2742 to the floor with a DO PASS AS AMENDED recommendation and BE REFERRED to the committee on Ways and Means by prior reference.

031

Rep. Monnes Anderson

Expresses some concern with the fiscal impact, but will be an aye vote.

042

 

VOTE:         7-0

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

044

Chair Kruse

The motion CARRIES.

047

Chair Kruse

Closes the work session on HB 2742 and adjourns the meeting at   10:40 a.m.

 

EXHIBIT SUMMARY

 

A – HB 3515, -2 amendments, staff, 2 pp.

B – HB 2511, -2 amendments, staff, 5 pp.

C – HB 2511, written testimony, Bruce Bishop, 9 pp.

D – HB 2742, -2 amendments, staff, 2 pp.