April 24, 2013 — A measure that directs the Oregon Health Authority to set up codes to bill non-medical expenses for patients on the Oregon Health Plan sailed through the Senate on a 26-1 vote yesterday.
Senate Bill 724 has been dubbed the “Air-Conditioner Bill” by Sen. Alan Bates, D-Medford, because it will help the Oregon Health Plan pay for things such as air conditioners for vulnerable patients, to keep them out of the hospital.
Bates reminded colleagues of a story that Gov. Kitzhaber often tells when touting the common sense of his healthcare delivery transformation: an elderly woman who went to the hospital for congestive heart failure simply because her home was overheated.
“We spent $100,000 on her for what we could have spent $500 on an air conditioner, but we had no way in healthcare to pay for that,” Bates said.
The doctor from Jackson County also said developing unconventional billing codes would pay for things like personal health navigators who can help Oregon Health Plan patients take the right medications so they stay out of the emergency room.
Coordinated care organizations have already started paying for air conditioners and wellness navigators, but have done so using their limited administrative budgets, where the items, which essentially help curb medical costs, cannot be easily tracked.
“Just taking it out of administrative overhead doesn’t work. We need a way to track it,” Bates told the Senate Health Committee earlier this month.
Jeff Heatherington, the president of FamilyCare, a Portland-area coordinated care organization, said its administrative budget is 8 percent on top of the global budget for medical expenses.
Trillium Health Plan in Lane County used its administrative budget to set up a tobacco cessation program, while HealthShare, the other Portland-area CCO, has used such funds to help community health workers provide items such as blankets.
“This is the original intent of the CCO model to allow us to offer flexible benefits,” Janet Meyer, the chief executive officer of HealthShare, told the Senate Health Committee.
The only opposition to SB 724 came from Sen. Fred Girod, R-Stayton, a dentist.
Fellow Republican Sen. Jeff Kruse of Roseburg supported the bill, but told lawmakers that the Oregon Health Authority would need approval from the Centers for Medicare & Medicaid Services to make it work.
“The health authority can’t do this arbitrarily,” said Kruse, who added that discussions between the state and federal government were ongoing to approve the practice for Medicaid clients.
The bill gives the Oregon Health Authority the statutory authority to make these code changes once it receives the federal go-ahead.
Bates said that the passage of SB 724 would send a message to the federal government that the Legislature supports the healthcare delivery transformation, including unconventional, big-picture assistance for things like air conditioners.
SB 724 heads to the House, where it has bipartisan support from Rep. Tim Freeman, R-Roseburg and Rep. Brian Clem, D-Salem.
