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83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
House Bill 2213
Introduced and printed pursuant to House Rule 12.00. Presession filed (at the request of House Interim Committee
on Behavioral Health and Health Care for Representative Rob Nosse)
SUMMARY
The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject
to consideration by the Legislative Assembly. It is an editor’s brief statement of the essential features of the
measure as introduced.The statement includes a measure digest written in compliance with applicable readability
standards.
Digest: The Act tells OHA to establish a medical loss ratio for CCOs. (Flesch Readability Score:
67.7).
Directs the Oregon Health Authority to establish a minimum medical loss ratio for coordinated
care organizations at 85 percent. Prohibits the authority from applying the minimum medical loss
ratio to revenue or expenditures of prepaid managed care health services organizations that provide
dental care to members of a coordinated care organization.
A BILL FOR AN ACT
Relating to coordinated care organizations.
Be It Enacted by the People of the State of Oregon:
SECTION 1. Section 2 of this 2025 Act is added to and made a part of ORS chapter 414.
SECTION 2.(1) As used in this section, “medical loss ratio” means the proportion of a
coordinated care organization’s global budget that is spent on health care services, quality
improvement and fraud prevention activities, as prescribed by the Oregon Health Authority
by rule consistent with federal law.
(2)(a) The authority shall establish a minimum medical loss ratio for coordinated care
organizations at 85 percent.
(b) The authority may not apply the minimum medical loss ratio established under this
section to revenue or expenditures of prepaid managed care health services organizations
that provide dental care to members of a coordinated care organization.
SECTION 3.Section 2 of this 2025 Act applies to contracts between a coordinated care
organization and the Oregon Health Authority entered into, amended or renewed on or after
the effective date of this 2025 Act.
NOTE:Matter in boldfaced type in an amended section is new; matter [italic and bracketed] is existing law to be omitted.
New sections are in boldfaced type.
LC 2590