summary
Introduced
01/13/2025
01/13/2025
In Committee
01/17/2025
01/17/2025
Crossed Over
Passed
Dead
06/27/2025
06/27/2025
Introduced Session
2025 Legislative Measures
Bill Summary
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.
AI Summary
This bill directs the Oregon Health Authority (OHA) to establish a minimum medical loss ratio (MLR) of 85 percent for coordinated care organizations (CCOs), which are healthcare networks that provide comprehensive medical services under a single contract. The medical loss ratio is defined as the proportion of a CCO's global budget spent on healthcare services, quality improvement, and fraud prevention activities, as determined by OHA rules consistent with federal regulations. Notably, the bill specifically exempts dental care providers within CCOs from this MLR requirement. The new MLR requirement will apply to all new, amended, or renewed contracts between CCOs and OHA starting from the bill's effective date in 2025. This legislation aims to ensure that a significant majority of CCO funds are directly used for patient care and related quality improvement efforts, rather than administrative overhead or profit.
Committee Categories
Health and Social Services
Sponsors (0)
No sponsors listed
Last Action
In committee upon adjournment. (on 06/27/2025)
Official Document
bill text
bill summary
Loading...
bill summary
Loading...
bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://olis.oregonlegislature.gov/liz/2025R1/Measures/Overview/HB2213 |
| Open Government Impact Statement for HB2213 INTRO | https://olis.oregonlegislature.gov/liz/2025R1/Downloads/MeasureAnalysisDocument/83202 |
| BillText | https://olis.oregonlegislature.gov/liz/2025R1/Downloads/MeasureDocument/HB2213/Introduced |
Loading...