Prepaid capitated health care service contracts
- • when fee for services to be paid
(1) The Department of Human Services shall execute prepaid capitated health service contracts for at least hospital or physician medical care, or both, with hospital and medical organizations, health maintenance organizations and any other appropriate public or private persons.
(2) For purposes of ORS 279A.025 (Application of Public Contracting Code), 279A.140 (State procurement of goods and services), 414.145 (Implementation of ORS 414.115, 414.125 or 414.135) and 414.610 (Legislative intent) to 414.640 (Selection of providers), instrumentalities and political subdivisions of the state are authorized to enter into prepaid capitated health service contracts with the Department of Human Services and shall not thereby be considered to be transacting insurance.
(3) In the event that there is an insufficient number of qualified bids for prepaid capitated health services contracts for hospital or physician medical care, or both, in some areas of the state, the department may continue a fee for service payment system.
(4) Payments to providers may be subject to contract provisions requiring the retention of a specified percentage in an incentive fund or to other contract provisions by which adjustments to the payments are made based on utilization efficiency. [1983 c.590 §3; 1991 c.66 §24; 2003 c.794 §275]
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