Health and life insurance
SB 1580: Grants Legislative Approval of Proposal for Establishing Coordinated Care Organizations (Chapter 8, 2012 Oregon Laws)
SB 1580 is the governor's health care transformation bill. It provides legislative approval of the proposals submitted by the Oregon Health Authority (OHA) to implement the Oregon Integrated and Coordinated Care Delivery System (CCOs) created by House Bill 3650 during the 2011 legislative session. The new delivery system replaces the prior system of managed care organizations, mental health organizations and dental care organizations that provide services to Medicaid and Oregon Health Plan patients.
SB 1580 allows the Department of Consumer and Business Services (DCBS) to enter into information sharing agreements with the OHA governing the disclosure of information reported to DCBS by insurers.
SB 1580 prohibits entities from discriminating in participation or reimbursement of providers based on licensure, but allows quality measures and cost controls. It establishes an appeal process for aggrieved providers and requires the OHA to adopt rules regarding network adequacy, provider types and qualifications, provider discipline, and provider reimbursement rates.
SB 1580 also creates a work group on patient safety and defensive medicine to recommend legislation in 2013 to improve patient safety, reduce medical liability costs, and more effectively compensate those injured as a result of medical errors. The bill requires the OHA to adopt CCO criteria, including minimum financial requirements, reserve and risk management criteria and requirements for coordination of care, governance, and community engagement. The bill creates a metrics and scoring committee appointed by the OHA to adopt quality and outcome measures.
SB 1580 also makes technical corrections.
- Effective Date: March 2, 2012