OHA Director Pat Allen talks about the distribution of the COVID-19 vaccine.
December brought significant development on the policy front as state and federal lawmakers worked to bolster the nation’s ability to respond to the COVID-19 pandemic before the end of 2020.
- State Telehealth pay parity: Andrew Stolfi, the Insurance Commissioner, announced an extension of the telehealth pay parity policy on par with in-person visits through June of 2021.
- Special Session: The governor calls legislators into a third special session this year. A medical liability protection bill dies in committee.
- A federal COVID-19 relief package is passed. Provisions include an unexpected deal on “surprise” medical billing, which includes an independent dispute resolution process sought by physicians and hospitals rather than benchmarking to a reimbursement rate in federal law.
Special Session Update
Protesters storm Capitol building, a last-minute medical liability protection bill fails.
Gov. Kate Brown called legislators into an in-person one-day special session on December 21 for emergency COVID relief. The day started on a note of drama as approximately 300 far-right protesters stormed two separate entrances into the Capitol to protest the pandemic restrictions on business and calling for the arrest of Kate Brown. Some of the protesters carried firearms and bear spray and many did not wear masks. Members of the public were not allowed in the Capitol. Legislators and staff were asked to follow safety protocols, including donning masks. Sen. Dallas Heard, R-Roseburg, refused to do so.
The negotiated agenda was narrow, with five bills allowing cocktails-to-go to support restaurants; extension of the eviction moratorium and funding for landlords; liability protections for schools; and emergency appropriations. Public hearings were held in advance of the special session. A last minute bill on medical liability protections that was introduced on Saturday failed in committee due to a lack of votes from House Democratic members. This means no Oregon liability shield for hospitals and other health care providers in today’s special session.
Summary of legislation
HB 4401 Housing Relief
- Provides grants directly to landlords on behalf of financially distressed tenants for up to 80 percent of unpaid rent between April 1, 2020, and June 30, 2021. Requires landlords to forgive the remaining unpaid rent for qualified tenants.
- Distributes rent assistance to recipients of the CARES Act Emergency Solution Grants, which will make payments directly to landlords.
- Prohibits eviction without cause until June 30, 2021.
- Prohibits claims against schools from damages due to COVID-19 infections if the school is in compliance with the Governor’s Executive Orders during the COVID-19 emergency.
- Allows restaurants during the pandemic emergency to sell and deliver mixed drinks in sealed containers to-go, similar to beer, wine and cider. Rules will limit the sale to two drinks per substantial food item ordered.
- Limits the fees that a third-party food platform (DoorDash, Grub Hub, etc.) may charge a restaurant to facilitate orders.
- Limits liability of hospitals, health maintenance organizations, health care providers and locations where health care services are provided for certain claims arising during COVID-19 emergency period. Long-term and residential care facilities as well as correction facilities are not included.
- Liability protection is not given to acts taken with gross negligence; reckless, wanton, or intentional misconduct, false claims, fraud, or deceptive acts or practices.
- Liability protection also is not given to delays or cancellations of elective or non-urgent procedures that create an irreversible risk of harm to the patient.
This is the $800 million budget bill for the special session.
- $100 million to the Emergency Board for appropriations
- $400 million for the state’s response to the COVID-19 emergency
- $100 million for wildfire recovery and prevention activities.
- $150 million for housing relief fund created under HB 4401 (landlord compensation)
- $50 million for Housing and Community Services (rental assistance program)
Federal Update $900 million COVID stimulus deal
A ban on surprise medical billing is included in the package
Agreement has been reached on a COVID-19 relief package that includes a ban on surprise (out-of-network) emergency medical bills. While everyone agrees that patients should be taken out of the middle of billing disputes, the proposed solutions — such as benchmarking reimbursement rates in law — cut payments for providers, especially emergency physicians subject to EMTALA. This tilts negotiating leverage to insurance companies to lower payments to providers. The deal would allow for payers and providers to negotiate payment for federal ERISA (self-funded insurers) claims through an independent dispute resolution process sought by associations for hospitals and physicians. It would bar arbiters from basing their decisions on Medicare and Medicaid rates, which tend to be much lower than commercial rates. Patients would be charged the same for co-pays and deductibles as in-network services.
The ban takes effect in 2022. Oregon’s ban on balance billing took effect in March of 2018. Negotiations are underway on the interim out-of-network reimbursement rate, which expires 2022.
Provisions of the federal stimulus package include the following:
- $600 direct payments for those earning under $75,000 and $1,200 for couples earning under $150,000
- Extended unemployment benefits
- Rental assistance fund of $25 billion. Extends the eviction moratorium until Jan. 31
- Additional $13 billion for the Supplemental Nutrition Assistance Program
- Small business Paycheck Protection Program loan fund of $284 billion.
- $10 billion for child care centers
- $68 billion to buy and distribute COVID-19 vaccines.
- Broadband access, $7 million.
- Transportation funding for airlines, mass transit, highways and Amtrak.
- $82 billion for schools and universities to assist with re-opening.
- $13 billion for farmers
- Tax-deductible meals — a provision sought by President Trump as well as a last $1.4 billion installment for a wall on the U.S.-Mexico border.
Interim Legislative Days
Legislators convened for extended interim legislative days December 3-18, with House committees meeting the first week and Senate committees meeting the second week. All of the meetings were virtual. It’s expected that the Oregon Legislature will meet virtually (closed to the public) appearing in person only for votes for the first three months of session, which starts Jan. 19.
The Spotlight Issue: COVID-19 Vaccine Distribution
Frontline health care workers were the first in line to receive COVID-19 vaccines, which arrived in Oregon on December 18. Oregon Health Authority (OHA) Director Pat Allen said Oregon will initially receive 147,000 doses. OHA has developed a plan for distribution which will factor in health equity. See the plan here. Phase one will be health care workers who have the potential for direct or indirect exposure to patients or infectious materials and people in long-term care facilities. This population is about 350,000 and each will need 2 doses. The next phase will be other essential workers and people at higher risk of severe COVID-19 illness, including people 65 years of age and older. Pat Allen cautioned that we’ll be well into Phase III until we will be back to normal and people can stop wearing masks. His closing remarks: “Vaccines don’t save people — vaccinations save people.”