CONFERENCE COMMITTEE ON HB 2498

 

June 10, 2005 Hearing Room D

11:00 A.M.      Tapes 1 - 2

 

MEMBERS PRESENT:            Rep. Billy Dalto, Chair

                                                Rep. Vicki Berger

                                                Sen. Kate Brown

Rep. Mitch Greenlick

                                                Sen. Laurie Monnes Anderson

                                                Sen. Jackie Winters

 

GUEST MEMBERS:               Rep. Chuck Burley

                                                Rep. Diane Rosenbaum

 

STAFF PRESENT:                  Sandy Thiele-Cirka, Committee Administrator

Pamella Andersen, Committee Assistant

 

MEASURES/ISSUES HEARD:

                        HB 2498B – 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 1, A

003

Chair Dalto

Calls the meeting to order at 11:06 a.m.  Opens a work session on HB 2498.

HB 2498 – WORK SESSION

013

Rep. Berger

Reviews the history of HB 2498.   Mentions and explains the –B4 (exhibit a) and –B5 amendments (exhibit b).

044

Holly Robinson

Legislative Counsel.  Explains the need to relate the bill to the Insurance Code.

054

Sen. Brown

Inquires about House rules.

056

Rep. Greenlick

Relates his understanding any issues relevant to the bill may be discussed.

065

Chair Dalto

Inquires about the –B4 amendments.

066

Robinson

Discusses section 3 of the original bill and relates the need to incorporate provisions of the bill into various sections of the Oregon Revised Statutes (ORS). 

105

Chair Dalto

Requests Robinson review the differences between the –B4 and –B5 amendments.

108

Robinson

Reviews the differences between the –B4 and –B5 amendments.

126

Chair Dalto

Asks if the language in section 2 is clear enough.

128

Robinson

Confirms, yes.  Provides details.

138

Rep. Greenlick

Questions the –B5 amendments on the insurance issue.

141

Robinson

Reviews the –B5 amendments as they relate to the specific issue of insurance coverage.  Mentions limitations in policy choice in the amendment.

165

Chair Dalto

Asks about the certain circumstances mentioned.

166

Robinson

Explains the circumstances.

170

Berger

States provisions apply based on the doctor’s recommendation.

172

Robinson

Confirms, yes.  Provides details.

178

Chair Dalto

Relates the goal appears to be to preclude a provider billing for an annual exam if only a clinical breast exam (CBE) was performed.

185

Robinson

Provides scenario that reflects policy differences between the two amendments in which the doctor might not be paid.  Continues section-by-section review.

219

Rep. Greenlick

Explains the provision appears odd because this is emerging standard of care.

224

Robinson

Reports the concern she expressed in drafting is, as part of evolving standards of care ambiguity is created.  Notes a Court of Appeals might question why the legislature didn’t choose to state details, resulting in possible litigation.

278

Chair Dalto

Calls proponents of the –B5 amendments forward to make their recommendations.

284

John Powell

Regence BlueCross/BlueShield.  Notes Regence is not necessarily the proponent of the amendment.  Relates concern with clarity in the law.  Reports Regence does not oppose the payment of these examinations, but pays for them, today.  Explains possibilities of when a physician might not be paid.  Relates the differences between what Regence requested of Legislative Counsel and the product created.  States Regence’ expectations with the amendment.  Believes the more specific language in subsection 1 limits, rather than allows more.  Comments the standard of care would be between the patient and physician. 

385

Chair Dalto

Invites Rep. Diane Rosenbaum to join the committee at the dais.

392

Sen. Brown

Clarifies her understanding of the differences between the –B4 and the –B5 amendments.

405

Sen. Monnes Anderson

Relates her concern about mandates, considering this is an emerging standard of care.  Asks if that was the intent of Regence, anticipating other mandates in the future.

427

Powell

Relates their desire to stick as closely to the original bill as possible.  Wishes to use the standard of care as a barometer that would change with medical practices.

TAPE 2, A

002

Rep. Greenlick

Asks if the bill is adopted with the –B4 amendments, will Regence continue to support the bill.

010

Powell

Responds he believes Regence would support the amended bill unless something unexpected should surface later.  Reiterates Regence pays for the procedures now and are not attempting to renege.

019

Sen. Winters

Requests clarification of the need for the change from the –B4 to –B5 amendments.

023

Powell

Relates Regence recommends using the “standard of medical care” language to allow for emergence of care standards.

034

Rep. Berger

Relates she is comfortable with the –B4 amendments, and doesn’t believe the –B5 amendments effectively clean up the language.

053

Rep. Rosenbaum

Points out the language in section 2 of the –B4 amendments, lines 8-9, is the language that was in the earlier version of the bill.

070

Chair Dalto

Asks Powell about providers billing for complete exams when they are not providing all components at the time.  Requests clarification.

082

Powell

Clarifies they are not unbundling what is included in the service.

106

Rep. Greenlick

Discusses current bundled CPT code for women’s exams.  Believes the intent is to add a different code so a physician can do the standard exam and in addition, do the CBE and charge the additional code.

123

Powell

Relates CPT codes are bundled into a package.  Notes when Regence pays for an exam they expect the exam to be complete.

141

Chair Dalto

States the standard of care is different depending on what provider you are speaking with.  Notes his intent with the –B4 amendments was for providers meeting the past standard to continue receiving standard payments, but for those performing the expanded exam, to receive expanded payments.

166

Sen. Monnes Anderson

Inquires if women not needing an expanded exam can receive the CBE with the –B4 amendment.

174

Powell

Confirms, yes.

176

Chair Dalto

Inquires if Powell is anticipating a provider seek payment for more than a CBE.

177

Powell

Responds, no.

181

Chair Dalto

Questions if Powell wants any changes to the –B4 amendment.

189

Powell

Believes a specific amendment is unnecessary to provide for separate payment.

198

Sen. Brown

Reiterates her earlier question about House rules.

206

Rep. Greenlick

Confirms anything related to the bill can be discussed.

218

Sen. Monnes Anderson

MOTION:  Moves to ADOPT HB 2498-B4 amendments dated 06/07/05.

230

 

VOTE:  6-0-0

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

 

Chair Dalto

The motion CARRIES.

235

Sen. Monnes Anderson

MOTION:  Moves HB 2498B to the floor with the recommendation that the House CONCUR in Senate amendments dated 04/27/05 and that the bill be FURTHER AMENDED by the –B4 amendments dated 06/07/05 and the measure be REPASSED.

254

 

VOTE:  6-0-0

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

 

Chair Dalto

The motion CARRIES.

SEN. WINTERS AND REP. DALTO will lead discussion on the floor.

262

Chair Dalto

Closes the work session on HB 2498.  Adjourns the meeting at 11:55 a.m.

 

EXHIBIT SUMMARY

 

  1. HB 2498, -B4 amendments, staff 3 pp
  2. HB 2498, -B5 amendments, staff 3 pp