Oregon has a law but still needs help

Oregon has a law but still needs help

Forest R Sexton CPO

I just returned from the ceremonial signing in the governor's office of
Oregon's O&P parity bill. We now have an official law guaranteeing our patients
reasonable coverage for O & P. I have included the text. We all owe Dr. Matt
Bradley a dept for this bill. Without his determination this law would still
be a bill. Please take the time to thank him personally <Email Address Redacted>
(mailto:<Email Address Redacted>) . He will be at our July 14th meeting to help
explain what he believes this bill will does for your practice and your patients.

Our licensure bill has been stalled intentionally in the Ways and Means
committee. This is a temporary situation. Manufacturers are asking for an
exemption from the law. The sponsoring agency ( the Oregon Advocacy Center) must not
grant that exemption. If they decide to move forward with the amendment in
place the only people required to be licensed in Oregon will be those already
certified. Anybody else will be allowed to compete with us without having any
formal training whatsoever. How have other states been able to prevent
exemptions for special interests?
 
Warranty is still on the table as well. All we have accomplished so far is
to have it stalled not removed from the table. This is a bill with severe
national ramifications. I appreciate the help that the national offices have
offered on this issue.
 
Here is our law
 
Forest R Sexton CPO
Pres. OOPA
 

     74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
 
 
                            Enrolled
 
                         House Bill 2517
 
Sponsored by Representative BUCKLEY, Senator BATES;
  Representative ESQUIVEL (at the request of Matthew W. Bradley,
  M.D.)
 
 
                     CHAPTER ................
 
 
                             AN ACT
 
 
Relating to medical devices.
 
Be It Enacted by the People of the State of Oregon:
 
  SECTION 1. { + Section 2 of this 2007 Act is added to and made
a part of the Insurance Code. + }
  SECTION 2. { + (1) All individual and group health insurance
policies providing coverage for hospital, medical or surgical
expenses shall include coverage for prosthetic and orthotic
devices that are medically necessary to restore or maintain the
ability to complete activities of daily living or essential
job-related activities and that are not solely for comfort or
convenience. The coverage required by this subsection includes
all services and supplies medically necessary for the effective
use of a prosthetic or orthotic device, including formulating its
design, fabrication, material and component selection,
measurements, fittings, static and dynamic alignments, and
instructing the patient in the use of the device.
  (2) As used in this section:
  (a) 'Orthotic device' means a rigid or semirigid device
supporting a weak or deformed leg, foot, arm, hand, back or neck,
or restricting or eliminating motion in a diseased or injured
leg, foot, arm, hand, back or neck.
  (b) 'Prosthetic device' means an artificial limb device or
appliance designed to replace in whole or in part an arm or a
leg.
  (3) The Director of the Department of Consumer and Business
Services shall adopt and annually update rules listing the
prosthetic and orthotic devices covered under this section. The
list shall be no more restrictive than the list of prosthetic and
orthotic devices and supplies in the Medicare fee schedule for
Durable Medical Equipment, Prosthetics, Orthotics and Supplies,
but only to the extent consistent with this section.
  (4) The coverage required by subsection (1) of this section may
be made subject to, and no more restrictive than, the provisions
of a health insurance policy that apply to other benefits under
the policy.
  (5) The coverage required by subsection (1) of this section
shall include any repair or replacement of a prosthetic or
orthotic device that is determined medically necessary to restore
or maintain the ability to complete activities of daily living or
 
 
 
Enrolled House Bill 2517 (HB 2517-A) Page 1
 
 
 
essential job-related activities and that is not solely for
comfort or convenience.
  (6) If coverage under subsection (1) of this section is
provided through a managed care plan, the insured shall have
access to medically necessary clinical care and to prosthetic and
orthotic devices and technology from not less than two distinct
Oregon prosthetic and orthotic providers in the managed care
plan's provider network. + }
                         ----------
 
 
Passed by House April 23, 2007
 
 
      ...........................................................
                                             Chief Clerk of House
 
      ...........................................................
                                                 Speaker of House
 
Passed by Senate May 18, 2007