This legislation significantly impacts the structure of health insurance regulations within Oregon. By requiring compliance with federal rules concerning preventive services, the bill enhances the accessibility of essential healthcare services for all plan enrollees. Additionally, the amendment empowers the Department of Consumer and Business Services to contract with more than five independent review organizations at once, thereby improving the state's capacity to manage external reviews of health insurance decisions. This move may lead to a more streamlined process for consumers seeking to contest denial of services.
Summary
House Bill 2282 seeks to amend existing regulations in Oregon regarding health benefit plans and establishes new guidelines for independent review organizations. Specifically, the bill mandates that health benefit plans not considered 'grandfathered' must cover preventive health services as defined by federal law effective from January 1, 2023. Furthermore, it prohibits any form of cost-sharing for these preventive services, ensuring they are provided at no additional charge to enrollees, aligning state law more closely with federal standards.
Contention
Notably, some legislators expressed concerns regarding the bill's financial implications for health insurers, particularly how mandating coverage without cost-sharing could affect overall premium costs. There was debate over whether the structure of the bill provides sufficient oversight to ensure that the quality of review undertaken by independent organizations meets rigorous standards. As these contracts are expected to be awarded biennially, questions arose around the transparency of the selection process and the potential for conflicts of interest within these organizations.