Reduction in scope of health services in event of insufficient resources
- • approval of Legislative Assembly or Emergency Board
- • notice to providers
(1) If insufficient resources are available during a contract period:
(a) The population of eligible persons determined by law may not be reduced.
(b) The reimbursement rate for providers and plans established under the contractual agreement may not be reduced.
(2) In the circumstances described in subsection (1) of this section, reimbursement shall be adjusted by reducing the health services for the eligible population by eliminating services in the order of priority recommended by the Health Evidence Review Commission, starting with the least important and progressing toward the most important.
(3) The Oregon Health Authority shall obtain the approval of the Legislative Assembly, or the Emergency Board if the Legislative Assembly is not in session, before instituting the reductions. In addition, providers contracting to provide health services under ORS 414.631 (Mandatory enrollment in coordinated care organization), 414.651 (Coordinated care organization contracts) and 414.688 (Commission established) to 414.745 (Liability of health care providers and plans) must be notified at least two weeks prior to any legislative consideration of such reductions. Any reductions made under this section shall take effect no sooner than 60 days following final legislative action approving the reductions.
(4) This section does not apply to reductions made by the Legislative Assembly in a legislatively adopted or approved budget. [1989 c.836 §8; 1991 c.753 §9; 2003 c.14 §195; 2009 c.595 §328; 2009 c.827 §18; 2011 c.720 §149]
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.