Healthcare

Adds new requirements for obtaining an initial license to operate and maintain a hospice program. [ Requires a hospice program to apply for a new initial license after a change in ownership. ] Prohibits individuals who have been excluded from participation in Medicare or Medicaid or have been found liable for fraud or abuse from holding an ownership interest in a hospice program. Requires the Oregon Health Authority to complete rulemaking within 24 months. Subject to exceptions, prohibits the authority from issuing new hospice licenses until rulemaking is complete. Declares an emergency, effective on passage.

] [ Authorizes ] Requires the State Treasurer to [ loan ] use up to [ 20 percent of ] $44 million from the Unclaimed Property and Estates Fund to guarantee a loan made to a rural [ hospitals ] hospital for financial stabilization. Declares an emergency, effective on passage.

Modifies the requirements for screening a hospital patient for presumptive eligibility for financial assistance. [ Prohibits the Oregon Health Authority from requiring certain home health agencies to comply with Medicare conditions of participation. ] [ Modifies the requirements for how the Department of Human Services must publish Residential Care Quality Measurement Program data. ] Removes the requirement that an applicant for a residential care facility administrator license hold a bachelor's degree in a health or social service related field. Allows a person residing in a correctional facility to receive prerelease medical assistance benefits under certain circumstances. [ Prohibits the authority or a coordinated care organization from requiring prior authorization for medical assistance coverage for repairing complex rehabilitation technology if the repair costs $1,500 or less. ] Modifies the requirements for meetings held by the Health Evidence Review Commission. Modifies the composition of the Medicaid Advisory Committee. Modifies the eligibility requirements for parent providers who are paid to provide attendant care services to their children. {See A-Eng Bill for omitted text.} Allows a full-time dentistry student enrolled in an out-of-state dental education program to practice dentistry without a license if the student is supervised by a faculty member of a dental education program accredited by the Commission on Dental Accreditation of the American Dental Association. Requires casualty or health insurance policies to provide coverage for medically necessary anesthesia services, regardless of duration, for any covered procedures. Requires dental insurers to follow certain rules for payment and denial of claims. Requires the Legislative Policy and Research Director to develop and propose to the [ Legislative Policy and Research Committee ] committees with jurisdiction over health care an insurance coverage mandate impact statement policy. Directs the [ committee ] committees to perform due diligence in considering the proposal and authorizes the [ committee ] committees to modify the proposal if the [ committee ] committees so [ determines ] determine , and then to adopt the policy. Repeals requirement that enrollees in individual or group policies or certificates of health insurance [ or members of coordinated care organizations ] be assigned by their insurer [ or organization ] to primary care providers under certain circumstances. Specifies exemptions from the requirement that pharmacy services administrative organizations must register with the Department of Consumer and Business Services as third party administrators. {See A-Eng Bill for omitted text.} Modifies requirements for the Prescription Drug Affordability Board's annual affordability determination for insulin products. Allows licensees of the Occupational Therapy Licensing Board and the Oregon Board of Physical Therapy to provide psilocybin services as licensed psilocybin service facilitators while providing occupational therapy or physical therapy services. {See A-Eng Bill for omitted text.} Lowers the age at which a naturopathic physician may request a retired license status from 70 years of age to [60] 65 years of age. Includes nurse practitioners and physician associates in the definition of "attending physician" for purposes of the treatment of workers’ compensable injuries. Declares an emergency, effective on passage.

Directs schools to have a cardiac emergency response plan as part of the procedures for responding to medical emergencies. Prescribes the requirements of a cardiac emergency response plan, including requirements related to automated external defibrillators. Takes effect July 1, [ 2026 ] 2027 .

Requires the Oregon Health Authority to adopt rules and procedures to allow a hospital to apply for a license as a rural emergency hospital. Takes effect on the 91st day following adjournment sine die.

Establishes coverage levels for doula services in the state medical assistance program and for health benefit plans that provide coverage for pregnancy and childbirth expenses. Requires the Oregon Health Authority, coordinated care organizations and health benefit plans that provide coverage for pregnancy and childbirth to provide coverage for services of lactation counselors. Specifies that minimum coverage level modifications for doula services and required coverage for lactation counselor services become operative on January 1, 2028. Directs the Traditional Health Workers Commission to establish a voluntary registration system for lactation counselors. Becomes operative on January 1, 2028. Creates the Oregon Perinatal Collaborative in the Oregon Health and Science University. Declares an emergency, effective on passage.

] Requires the Oregon Health Authority to develop a transparent and data-driven process for developing capitation rates for coordinated care organizations. [ Requires the Oregon Health Policy Board to establish a process for public review of and comment on the authority's rate development process. Requires the authority to commission an independent review of the current rate development process and report back to the Legislative Assembly. ] Requires the authority to prepare a medical assistance cost impact statement before adopting rules other than procedural rules. [ Prohibits the authority from adopting a new rule, program or contractual requirement that will cost $1 million or more during a biennium. Sunsets on January 2, 2028. ] [ Imposes a three-year moratorium on the requirement for a coordinated care organization to spend a portion of the organization's annual net income or reserves on addressing health disparities and the social determinants of health. ] Declares an emergency, effective on passage.

] Requires the Oregon Health Authority and coordinated care organizations to ensure that access to behavioral health treatment in the medical assistance program is comparable to access to medical and surgical treatment and that limitations are applied to behavioral health treatment no more stringently than to medical and surgical treatment. Prohibits the authority or a contracted external quality review organization, under certain circumstances, from making a negative finding about or imposing a penalty on a coordinated care organization based on documents or templates created by the authority for use by a coordinated care organization. Modifies certain statutes to clarify roles and responsibilities for the delivery of behavioral health services and to update terminology. Modifies the types of providers that may be reimbursed in the state medical assistance program for the cost of health services delivered using telemedicine. Becomes operative on January 1, 2027. Takes effect on the 91st day following adjournment sine die.

Modifies the requirements for Medicaid supplemental reimbursements paid to emergency medical services providers. Declares an emergency, effective on passage.

] Requires the Oregon Health Authority to, no later than June 30, 2027, adopt a uniform process for credentialing [ organizational ] behavioral health providers and [ establish a centralized portal for processing applications ] select an existing electronic credentialing system . Prohibits a coordinated care organization from requiring a behavioral health provider to comply with any additional credentialing procedures. Requires a coordinated care organization to begin using the selected electronic credentialing system no later than July 1, 2027. Requires the authority to minimize unnecessary administrative burden for individual and organizational behavioral health providers who serve medical assistance recipients and to report biennially to the Governor and the Legislative Assembly. Allows certain licensed behavioral health care providers to provide supervision for other behavioral health care providers who hold different license types. [ Provides that the Mental Health Regulatory Agency will provide administrative and regulatory oversight and centralized service for the State Board of Licensed Social Workers. ] Takes effect on the 91st day following adjournment sine die.