Signed by Governor Kate Brown

Vote Smart's Synopsis:

Vote to pass a bill that establishes standards for non-profit hospitals.

Highlights:

• Requires the assistance policy of a nonprofit hospital to (Sec. 2):

• Adjust a patient’s cost by 100 percent if the patient’s cost is no more than 200 percent of the federal poverty guidelines, and adjust a patient’s cost through a sliding scale policy if the patient’s cost is more than 200 percent of the federal poverty guidelines;

• Apply to all of the hospital’s nonprofit affiliated clinics;

• Be translated into each language used by the lesser of 1,000 people or 5 percent of the population within the service area of the nonprofit hospital;

• Guarantee that language translator services are available so that languages not included in the previous sub-highlight can be translated upon request; and

• Apply to all medically necessary services or supplies.

• Amends a nonprofit hospital’s written financial assistance policy to require adjusting a patient’s cost by (Sec. 3):

• A minimum of 75 percent if the household income of the patient is between 200 and 300 percent of the federal poverty guidelines;

• A minimum of 50 percent if the household income of the patient is between 300 and 350 percent of the federal poverty guidelines; and

• A minimum of 25 percent if the household income of the patient is between 350 and 400 percent of the federal poverty guidelines.

• Requires a hospital or hospital-affiliated clinic to conduct a screening to determine if the patient qualifies for financial assistance through the financial assistance policy of the hospital, or the state medical assistance program (Sec. 4):

• If requested by the patient or an individual authorized by a patient; and

• Before transferring an unpaid charge for services to a debt collector or referring an unpaid charge for collection.

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from charging interest on a patient’s medical debt if they qualify for financial assistance (Sec. 4).

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from collecting a medical debt from a patient’s child or other family member who is not financially responsible for the debt (Sec. 4).

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from charging interest on a medical debt owed by an individual who does not qualify for medical assistance that is greater than the weekly average one-year constant maturity Treasury yield, as published by the Board of Governors of the Federal Reserve System (Sec. 4).

• Specifies that charges for services performed in section 4 applies on or after the effective date of this 2019 Act (Sec. 13).

• Requires nonprofit hospitals to post specific information regarding its community health needs assessment on their website, including (Sec. 5):

• A description of the health care needs in the hospital’s community health needs assessment;

• A three year strategy developed to treat the health care needs of the community;

• Annual progress of the strategy; and

• Opportunities for public participation in the assessment and development of the strategy.

• Expands the definition of “community benefit” to include a program or activity that provides treatment or promotes health and healing, addresses health disparities or addresses the social determinants of health in response to an identified community need (Sec. 10).

• Requires the Oregon Health Authority to establish a community benefit spending floor centered on objective data and criteria every two years (Sec. 6).

• Specifies that Section 6 and amendments to section 2 by section 3 become operative on January 1, 2021 (Sec. 14). 

• Requires hospitals to annually report to the Oregon Health Authority relevant information concerning all healthcare facilities and affiliated clinics owned in part or in full by the hospital or operating under the same brand as the hospital (Sec. 7).

• Specifies that a failure in filing a timely report can be subject to a civil penalty of up to $500 per day (Sec. 7).

• Prohibits insurers that offer policies or certificates of health insurance from preventing a hospital, as a condition of reimbursing a claim for hospital services, from paying or waiving all or a portion of a copayment or deductible owed by an insured under the policy or certificate (Sec. 9).

• Establishes that Section 9 of this 2019 Act is added to and made a part of the Insurance Code (Sec. 8).

• Requires the Oregon Health Authority to report, no later than December 31, 2022, to the interim committees of the Legislative Assembly related to health, on the implementations and amendments of this 2019 Act (Sec. 12).

• Defines “adjust” as to reduce a patient’s cost by a specified percentage (Sec. 1).

• Defines “medically necessary” as necessary to prevent, diagnose, or treat an illness, injury, condition, or disease, or the symptoms of an illness, injury, condition, or disease; and meeting accepted standards of medicine (Sec. 1).

• Defines “patient’s cost” as the portion of charges billed to a patient for care received at a hospital or a hospital-affiliated clinic that are not reimbursed by insurance or a publicly funded health care program (Sec. 1).

• Defines “social determinants of health” as the social, economic, and environmental conditions in which people are born, grow, work, live, and age, shaped by the distribution of money, power, and resources at local, national, and global levels, institutional bias, discrimination, racism, and other factors (Sec. 1).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes standards for non-profit hospitals.

Highlights:

• Requires the assistance policy of a nonprofit hospital to (Sec. 2):

• Adjust a patient’s cost by 100 percent if the patient’s cost is no more than 200 percent of the federal poverty guidelines, and adjust a patient’s cost through a sliding scale policy if the patient’s cost is more than 200 percent of the federal poverty guidelines;

• Apply to all of the hospital’s nonprofit affiliated clinics;

• Be translated into each language used by the lesser of 1,000 people or 5 percent of the population within the service area of the nonprofit hospital;

• Guarantee that language translator services are available so that languages not included in the previous sub-highlight can be translated upon request; and

• Apply to all medically necessary services or supplies.

• Amends a nonprofit hospital’s written financial assistance policy to require adjusting a patient’s cost by (Sec. 3):

• A minimum of 75 percent if the household income of the patient is between 200 and 300 percent of the federal poverty guidelines;

• A minimum of 50 percent if the household income of the patient is between 300 and 350 percent of the federal poverty guidelines; and

• A minimum of 25 percent if the household income of the patient is between 350 and 400 percent of the federal poverty guidelines.

• Requires a hospital or hospital-affiliated clinic to conduct a screening to determine if the patient qualifies for financial assistance through the financial assistance policy of the hospital, or the state medical assistance program (Sec. 4):

• If requested by the patient or an individual authorized by a patient; and

• Before transferring an unpaid charge for services to a debt collector or referring an unpaid charge for collection.

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from charging interest on a patient’s medical debt if they qualify for financial assistance (Sec. 4).

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from collecting a medical debt from a patient’s child or other family member who is not financially responsible for the debt (Sec. 4).

• Prohibits a hospital, nonprofit hospital-affiliated clinic, or other debt collector from charging interest on a medical debt owed by an individual who does not qualify for medical assistance that is greater than the weekly average one-year constant maturity Treasury yield, as published by the Board of Governors of the Federal Reserve System (Sec. 4).

• Specifies that charges for services performed in section 4 applies on or after the effective date of this 2019 Act (Sec. 13).

• Requires nonprofit hospitals to post specific information regarding its community health needs assessment on their website, including (Sec. 5):

• A description of the health care needs in the hospital’s community health needs assessment;

• A three year strategy developed to treat the health care needs of the community;

• Annual progress of the strategy; and

• Opportunities for public participation in the assessment and development of the strategy.

• Expands the definition of “community benefit” to include a program or activity that provides treatment or promotes health and healing, addresses health disparities or addresses the social determinants of health in response to an identified community need (Sec. 10).

• Requires the Oregon Health Authority to establish a community benefit spending floor centered on objective data and criteria every two years (Sec. 6).

• Specifies that Section 6 and amendments to section 2 by section 3 become operative on January 1, 2021 (Sec. 14). 

• Requires hospitals to annually report to the Oregon Health Authority relevant information concerning all healthcare facilities and affiliated clinics owned in part or in full by the hospital or operating under the same brand as the hospital (Sec. 7).

• Specifies that a failure in filing a timely report can be subject to a civil penalty of up to $500 per day (Sec. 7).

• Prohibits insurers that offer policies or certificates of health insurance from preventing a hospital, as a condition of reimbursing a claim for hospital services, from paying or waiving all or a portion of a copayment or deductible owed by an insured under the policy or certificate (Sec. 9).

• Establishes that Section 9 of this 2019 Act is added to and made a part of the Insurance Code (Sec. 8).

• Requires the Oregon Health Authority to report, no later than December 31, 2022, to the interim committees of the Legislative Assembly related to health, on the implementations and amendments of this 2019 Act (Sec. 12).

• Defines “adjust” as to reduce a patient’s cost by a specified percentage (Sec. 1).

• Defines “medically necessary” as necessary to prevent, diagnose, or treat an illness, injury, condition, or disease, or the symptoms of an illness, injury, condition, or disease; and meeting accepted standards of medicine (Sec. 1).

• Defines “patient’s cost” as the portion of charges billed to a patient for care received at a hospital or a hospital-affiliated clinic that are not reimbursed by insurance or a publicly funded health care program (Sec. 1).

• Defines “social determinants of health” as the social, economic, and environmental conditions in which people are born, grow, work, live, and age, shaped by the distribution of money, power, and resources at local, national, and global levels, institutional bias, discrimination, racism, and other factors (Sec. 1).

Full Bill Text