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Bill > HB3964


OR HB3964

Relating to health insurance contract negotiations.


summary

Introduced
04/16/2025
In Committee
04/22/2025
Crossed Over
Passed
Dead

Introduced Session

2025 Legislative Measures

Bill Summary

The statement includes a measure digest written in compliance with applicable readability standards. Digest: This Act makes a process for some health insurers and some health providers to choose to mediate and arbitrate when they are not able to agree on a new contract. Tells the Governor to make the final decision and permits penalties. (Flesch Readability Score: 60.1). Establishes a voluntary mediation and arbitration process that certain health insurers and pro- viders may participate in if the insurer and provider are unable to reach an agreement during a contract renewal negotiation. Establishes that the Governor, or a designee, shall issue a final de- termination in the arbitration process and may impose penalties for failure to comply.

AI Summary

This bill establishes a voluntary mediation and binding arbitration process for health insurers and providers when they cannot agree on contract renewal terms that would impact over 30,000 Oregonians. The process begins with a 15-day cooling-off period, after which the parties must choose a mediator (either a senior judge or a qualified legal practitioner with extensive health insurance and mediation experience). If they cannot agree on a mediator, each side submits three names to the Governor, who then selects one. The parties then engage in mediation for up to 120 days or until a mediator declares an impasse. If no agreement is reached, another 15-day cooling-off period follows, during which both parties develop final offers. Arbitration then occurs with the Governor or a designated representative, who must issue a final determination within five days. The determination sets contract terms and arbitration costs. If either party fails to implement the determination, they must pay the full mediation and arbitration costs and can be subject to civil penalties up to $10,000, plus an additional $1,000 per day of non-compliance, which will be paid into the state's General Fund. This process is designed to help resolve contract negotiations between health insurers and providers without disrupting health care services.

Committee Categories

Health and Social Services

Sponsors (2)

Last Action

Referred to Behavioral Health and Health Care. (on 04/22/2025)

bill text


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