HB 3076A Regulates hospital & clinic spending and reimbursements

VOTE: NO – Signed into Law by Gov Brown

Status (overview) of bill:https://olis.leg.state.or.us/liz/2019R1/Measures/Overview/HB3076
This bill requires nonprofit hospitals and their nonprofit affiliated clinics to establish financial assistance policies meeting specified criteria, including reducing charges to low-income patients, and establishes consumer rights with respect to billing and charges for services provided.

Personal Choice and Responsibility
Allows hospitals the flexibility to waive all or part of copayments or deductibles as condition of reimbursement for services under policy or certificate of insurance. But, also requires a minimum community benefit spending policy that will limit the flexibility.

Fiscal Responsibility
Community benefits are defined as services, spending, or actions taken by a hospital in the community, in exchange for its tax-exempt status. There is no defined minimum community benefit a hospital must provide. According to OHA’s Office of Health Analytics Community Benefit Report, Oregon hospitals provided $2.2 billion in community benefits in fiscal year 2016, representing a 14% increase compared to the prior fiscal year, attributed largely to unreimbursed Medicare and Medicaid rates. Unreimbursed costs that hospitals incur in providing critical health services account for approximately 83% of total community benefit with 73% due to unreimbursed Medicare and Medicaid. HB 3076A regulates the charity care policies of nonprofit hospitals and health systems.

Limited Government
Requires Oregon Health Authority to establish community benefit spending floor. Requires each hospital to conduct assessment of community health care needs and develop three-year strategy. Specifies requirements for needs assessment and development of strategy. Requires hospital to post strategy and progress on the implementation and opportunities for public participation on website. Provides remedies and penalties for failing to meet spending floor. Requires nonprofit hospital system to report specified information annually to OHA.

Free Markets
The benefits that hospitals provide varies by circumstances and the peopled served. By restricting hospitals to a pre-determined plan removes the flexibility to service the need at hand. In trying to ensure Community Benefit spending, and prevent predatory debt collection by non-profit hospitals, it limits what hospitals are able to do for clients.

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