Bill > HB4127

This bill establishes a payment mechanism for "prohibited entities," defined as nonprofit reproductive health care providers enrolled in the state medical assistance program (Medicaid) but not eligible for federal Medicaid funds. The Oregon Health Authority will pay these entities on a fee-for-service basis for services rendered to medical assistance recipients, using state funds, not federal Medicaid funds, and ensuring provider enrollment standards are met. The authority will also conduct biennial rate analyses to ensure access to reproductive health services. Additionally, the bill addresses situations where coordinated care organizations (managed care plans that coordinate care for Medicaid recipients) may have paid prohibited entities between July 4, 2025, and the bill's effective date, allowing them to recover overpayments for routine business reasons but not solely because the provider is ineligible for federal funds. A grant program is also outlined to support these prohibited entities, contingent on a state or federal action preventing them from maintaining enrollment in the state medical assistance program, and this grant program will also be funded with state, not federal, money. The bill declares an emergency, meaning it takes effect immediately upon passage.