With Oregon’s legislature set to convene on Feb. 1 for a short session, legislators are limited to two personal bills, but that doesn’t mean there’s a shortage of health care legislation being proposed.
That being said, State of Reform looked over the bills filed so far and selected three to watch as the 35-day session begins.
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The first is SB 1530, which would require health insurance to cover specific fertility services and treatments. This would include procedures recommended by doctors, including storing reproductive specimens, diagnostic testing, a minimum of three complete oocyte retrievals with unlimited embryo transfers, and other procedures. The bill creates a carveout for religious insurers from paying if coverage is contrary to their beliefs.
The bill further directs the Oregon Health Authority to explore inequalities in assisted reproduction people who are LGBTQ, or members of other minority gender identities or sexual orientations.
As part of this, OHA is required to issue a report of its findings by the end of January 2025. The report should include recommendations to ensure that the programs are distributed in an equitable, inclusive and non-exploitative way for low-income Oregonians enrolled in medical assistance programs.
The second bill is HB 4039, which would modify financial requirements for coordinated care organization expenditures on social determinants of health and equity. It would require the Oregon Health Authority to spend at least 3% of its expenses in administering fee-for-service programs on social determinants of health and health equity. It further bans OHA from adopting rules that restrict coordinated care organizations from distributions or other expenditures above 200% of minimum required risk-based capital.
The third bill, HB 4083, would require individual and group health insurance policies, health care service contractors, multiple employer welfare arrangements and state medical assistance programs to provide reimbursement for at least three primary care visits each year, in addition to one annual preventative primary care visit without cost sharing. The bill exempts commercial plans offered to public employees by the Public Employees’ Benefit Board and the Oregon Educators Benefit Board.
It would also prohibit the insurance providers required to cover additional visits from denying coverage for services provided by behavioral health home and patient centered primary care because services were provided on the same day or in the same facility. It also limits copayments for these services.
Finally, it would ban insurance policies from requiring prior authorization from specialty behavioral health services provided at behavioral health homes or patient centered primary care homes.
In a recent conversation with Sen. Deb Patterson, she highlighted SB 1530 as one the Senate Committee on Health Care will be taking up, as well as SB 1528, which would establish a brain injury resource facilitation center.