Bill Text: OR HB2719 | 2013 | Regular Session | Introduced

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Bill Title: Relating to expansion of medical assistance coverage.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Failed) 2013-07-08 - In committee upon adjournment. [HB2719 Detail]

Download: Oregon-2013-HB2719-Introduced.html

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     77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

LC 869

                         House Bill 2719

Sponsored by Representative THOMPSON

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.

  Implements expansion of medical assistance eligibility required
by Patient Protection and Affordable Care Act. Repeals expansion
on January 2, 2017, when federal match rate drops to 95 percent
of state costs.

                        A BILL FOR AN ACT
Relating to expansion of medical assistance coverage; creating
  new provisions; amending ORS 411.404, 414.025, 414.706 and
  416.350 and section 9, chapter 736, Oregon Laws 2003; and
  repealing ORS 414.428.
Be It Enacted by the People of the State of Oregon:
  SECTION 1. ORS 414.025 is amended to read:
  414.025. As used in this chapter and ORS chapters 411 and 413,
unless the context or a specially applicable statutory definition
requires otherwise:
  (1)(a) 'Alternative payment methodology' means a payment other
than a fee-for-services payment, used by coordinated care
organizations as compensation for the provision of integrated and
coordinated health care and services.
  (b) 'Alternative payment methodology' includes, but is not
limited to:
  (A) Shared savings arrangements;
  (B) Bundled payments; and
  (C) Payments based on episodes.
  (2) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, aid granted under ORS 412.001 to
412.069 and 418.647 or federal Supplemental Security Income
payments.
  (3) 'Categorically needy' means, insofar as funds are available
for the category, a person who is a resident of this state and
who:
  (a) Is receiving a category of aid.
  (b) Would be eligible for a category of aid but is not
receiving a category of aid.
  (c) Is in a medical facility and, if the person left such
facility, would be eligible for a category of aid.
  (d) Is under the age of 21 years and would be a dependent child
as defined in ORS 412.001 except for age and regular attendance
in school or in a course of professional or technical training.
  (e)(A) Is a caretaker relative, as defined in ORS 412.001, who
cares for a child who would be a dependent child except for age
and regular attendance in school or in a course of professional
or technical training; or
  (B) Is the spouse of the caretaker relative.
  (f) Is under the age of 21 years and:
  (A) Is in a foster family home or licensed child-caring agency
or institution and is one for whom a public agency of this state
is assuming financial responsibility, in whole or in part; or
  (B) Is 18 years of age or older, is one for whom federal
financial participation is available under Title XIX or XXI of
the federal Social Security Act and who met the criteria in
subparagraph (A) of this paragraph immediately prior to the
person's 18th birthday.
  (g) Is a spouse of an individual receiving a category of aid
and who is living with the recipient of a category of aid, whose
needs and income are taken into account in determining the cash
needs of the recipient of a category of aid, and who is
determined by the Department of Human Services to be essential to
the well-being of the recipient of a category of aid.
  (h) Is a caretaker relative as defined in ORS 412.001 who cares
for a dependent child receiving aid granted under ORS 412.001 to
412.069 and 418.647 or is the spouse of the caretaker relative.
  (i) Is under the age of 21 years, is in a youth care center and
is one for whom a public agency of this state is assuming
financial responsibility, in whole or in part.
  (j) Is under the age of 21 years and is in an intermediate care
facility which includes institutions for persons with
developmental disabilities.
  (k) Is under the age of 22 years and is in a psychiatric
hospital.
  (L) Is under the age of 21 years and is in an independent
living situation with all or part of the maintenance cost paid by
the Department of Human Services.
  (m) Is a member of a family that received aid in the preceding
month under ORS 412.006 or 412.014 and became ineligible for aid
due to increased hours of or increased income from employment. As
long as the member of the family is employed, such families will
continue to be eligible for medical assistance for a period of at
least six calendar months beginning with the month in which such
family became ineligible for assistance due to increased hours of
employment or increased earnings.
  (n) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part.
  (o) Is an individual or is a member of a group who is required
by federal law to be included in the state's medical assistance
program in order for that program to qualify for federal funds.
  (p) Is an individual or member of a group who, subject to the
rules of the department or the Oregon Health Authority, may
optionally be included in the state's medical assistance program
under federal law and regulations concerning the availability of
federal funds for the expenses of that individual or group.
  (q) Is a pregnant woman who would be eligible for aid granted
under ORS 412.001 to 412.069 and 418.647, whether or not the
woman is eligible for cash assistance.
  (r) Except as otherwise provided in this section, is a pregnant
woman or child for whom federal financial participation is
available under Title XIX or XXI of the federal Social Security
Act.
  (s) Is not otherwise categorically needy and is not eligible
for care under Title XVIII of the federal Social Security Act
 { - or is not a full-time student in a post-secondary education
program as defined by the department or the authority by rule - }
, but whose family income is  { + above 100 percent of the
federal poverty level and + } at or below  { + 138 percent of + }
the federal poverty level   { - and whose family investments and

savings equal less than the investments and savings limit
established by the department or the authority by rule - } .
  (t) Would be eligible for a category of aid but for the receipt
of qualified long term care insurance benefits under a policy or
certificate issued on or after January 1, 2008. As used in this
paragraph, 'qualified long term care insurance' means a policy or
certificate of insurance as defined in ORS 743.652 (7).
  (u) Is eligible for the Health Care for All Oregon Children
program established in ORS 414.231.
  (v) Is dually eligible for Medicare and Medicaid and receiving
care through a coordinated care organization.
  (4) 'Community health worker' means an individual who:
  (a) Has expertise or experience in public health;
  (b) Works in an urban or rural community, either for pay or as
a volunteer in association with a local health care system;
  (c) To the extent practicable, shares ethnicity, language,
socioeconomic status and life experiences with the residents of
the community where the worker serves;
  (d) Assists members of the community to improve their health
and increases the capacity of the community to meet the health
care needs of its residents and achieve wellness;
  (e) Provides health education and information that is
culturally appropriate to the individuals being served;
  (f) Assists community residents in receiving the care they
need;
  (g) May give peer counseling and guidance on health behaviors;
and
  (h) May provide direct services such as first aid or blood
pressure screening.
  (5) 'Coordinated care organization' means an organization
meeting criteria adopted by the Oregon Health Authority under ORS
414.625.
  (6) 'Dually eligible for Medicare and Medicaid' means, with
respect to eligibility for enrollment in a coordinated care
organization, that an individual is eligible for health services
funded by Title XIX of the Social Security Act and is:
  (a) Eligible for or enrolled in Part A of Title XVIII of the
Social Security Act; or
  (b) Enrolled in Part B of Title XVIII of the Social Security
Act.
  (7) 'Global budget' means a total amount established
prospectively by the Oregon Health Authority to be paid to a
coordinated care organization for the delivery of, management of,
access to and quality of the health care delivered to members of
the coordinated care organization.
  (8) 'Health services' means at least so much of each of the
following as are funded by the Legislative Assembly based upon
the prioritized list of health services compiled by the Health
Evidence Review Commission under ORS 414.690:
  (a) Services required by federal law to be included in the
state's medical assistance program in order for the program to
qualify for federal funds;
  (b) Services provided by a physician as defined in ORS 677.010,
a nurse practitioner certified under ORS 678.375 or other
licensed practitioner within the scope of the practitioner's
practice as defined by state law, and ambulance services;
  (c) Prescription drugs;
  (d) Laboratory and X-ray services;
  (e) Medical equipment and supplies;
  (f) Mental health services;
  (g) Chemical dependency services;
  (h) Emergency dental services;
  (i) Nonemergency dental services;
  (j) Provider services, other than services described in
paragraphs (a) to (i), (k), (L) and (m) of this subsection,

defined by federal law that may be included in the state's
medical assistance program;
  (k) Emergency hospital services;
  (L) Outpatient hospital services; and
  (m) Inpatient hospital services.
  (9) 'Income' has the meaning given that term in ORS 411.704.
  (10) 'Investments and savings' means cash, securities as
defined in ORS 59.015, negotiable instruments as defined in ORS
73.0104 and such similar investments or savings as the department
or the authority may establish by rule that are available to the
applicant or recipient to contribute toward meeting the needs of
the applicant or recipient.
  (11) 'Medical assistance' means so much of the medical, mental
health, preventive, supportive, palliative and remedial care and
services as may be prescribed by the authority according to the
standards established pursuant to ORS 414.065, including premium
assistance and payments made for services provided under an
insurance or other contractual arrangement and money paid
directly to the recipient for the purchase of health services and
for services described in ORS 414.710.
  (12) 'Medical assistance' includes any care or services for any
individual who is a patient in a medical institution or any care
or services for any individual who has attained 65 years of age
or is under 22 years of age, and who is a patient in a private or
public institution for mental diseases. 'Medical assistance '
does not include care or services for an inmate in a nonmedical
public institution.
  (13) 'Patient centered primary care home' means a health care
team or clinic that is organized in accordance with the standards
established by the Oregon Health Authority under ORS 414.655 and
that incorporates the following core attributes:
  (a) Access to care;
  (b) Accountability to consumers and to the community;
  (c) Comprehensive whole person care;
  (d) Continuity of care;
  (e) Coordination and integration of care; and
  (f) Person and family centered care.
  (14) 'Peer wellness specialist' means an individual who is
responsible for assessing mental health service and support needs
of the individual's peers through community outreach, assisting
individuals with access to available services and resources,
addressing barriers to services and providing education and
information about available resources and mental health issues in
order to reduce stigmas and discrimination toward consumers of
mental health services and to provide direct services to assist
individuals in creating and maintaining recovery, health and
wellness.
  (15) 'Person centered care' means care that:
  (a) Reflects the individual patient's strengths and
preferences;
  (b) Reflects the clinical needs of the patient as identified
through an individualized assessment; and
  (c) Is based upon the patient's goals and will assist the
patient in achieving the goals.
  (16) 'Personal health navigator' means an individual who
provides information, assistance, tools and support to enable a
patient to make the best health care decisions in the patient's
particular circumstances and in light of the patient's needs,
lifestyle, combination of conditions and desired outcomes.
  (17) 'Quality measure' means the measures and benchmarks
identified by the authority in accordance with ORS 414.638.
  (18) 'Resources' has the meaning given that term in ORS
411.704. For eligibility purposes, 'resources' does not include
charitable contributions raised by a community to assist with
medical expenses.
  SECTION 2. ORS 414.706 is amended to read:
  414.706. The Legislative Assembly shall approve and fund health
services to the following persons:
  (1) Persons who are categorically needy as described in ORS
414.025 (3)(o) and (p);
  (2) Pregnant women with incomes no more than 185 percent of the
federal poverty guidelines;
  (3) Persons under 19 years of age with incomes no more than 200
percent of the federal poverty guidelines;
  (4) Persons described in ORS 414.708; and
  (5) Persons 19 years of age or older with incomes   { - no more
than - }  { +  above + } 100 percent of the federal poverty
guidelines  { + and at or below 138 percent of the federal
poverty guidelines + } who do not have federal Medicare coverage.
  SECTION 3. ORS 411.404 is amended to read:
  411.404. (1) The Department of Human Services shall determine
eligibility for medical assistance according to criteria
prescribed by rule in consultation with the Oregon Health
Authority that take into account:
  (a) The requirements and needs of the applicant and of the
spouse and dependents of the applicant;
  (b) The income, resources and maintenance available to the
applicant; and
  (c) The responsibility of the spouse of the applicant and, with
respect to an applicant who is blind or is permanently and
totally disabled or is under 21 years of age, the responsibility
of the parents.
  (2) Rules adopted by the department under subsection (1) of
this section:
    { - (a) Shall disregard resources for those who are eligible
for medical assistance only by reason of ORS 414.025 (3)(s),
except for the resources described in ORS 414.025 (3)(s). - }
    { - (b) - }  { +  (a) + } May disregard income and resources
within the limits required or permitted by federal law,
regulations or orders.
    { - (c) - }  { +  (b) + } May not require any needy person
over 65 years of age, as a condition of entering or remaining in
a hospital, nursing home or other congregate care facility, to
sell any real property normally used as the person's home.
  (3) Notwithstanding subsections (1) and (2) of this section,
the authority may adopt rules necessary to implement the Health
Care for All Oregon Children program established by ORS 414.231
or applicable provisions of federal law.
  SECTION 4. ORS 414.025, as amended by section 1 of this 2013
Act, is amended to read:
  414.025. As used in this chapter and ORS chapters 411 and 413,
unless the context or a specially applicable statutory definition
requires otherwise:
  (1)(a) 'Alternative payment methodology' means a payment other
than a fee-for-services payment, used by coordinated care
organizations as compensation for the provision of integrated and
coordinated health care and services.
  (b) 'Alternative payment methodology' includes, but is not
limited to:
  (A) Shared savings arrangements;
  (B) Bundled payments; and
  (C) Payments based on episodes.
  (2) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, aid granted under ORS 412.001 to
412.069 and 418.647 or federal Supplemental Security Income
payments.
  (3) 'Categorically needy' means, insofar as funds are available
for the category, a person who is a resident of this state and
who:
  (a) Is receiving a category of aid.
  (b) Would be eligible for a category of aid but is not
receiving a category of aid.
  (c) Is in a medical facility and, if the person left such
facility, would be eligible for a category of aid.
  (d) Is under the age of 21 years and would be a dependent child
as defined in ORS 412.001 except for age and regular attendance
in school or in a course of professional or technical training.
  (e)(A) Is a caretaker relative, as defined in ORS 412.001, who
cares for a child who would be a dependent child except for age
and regular attendance in school or in a course of professional
or technical training; or
  (B) Is the spouse of the caretaker relative.
  (f) Is under the age of 21 years and:
  (A) Is in a foster family home or licensed child-caring agency
or institution and is one for whom a public agency of this state
is assuming financial responsibility, in whole or in part; or
  (B) Is 18 years of age or older, is one for whom federal
financial participation is available under Title XIX or XXI of
the federal Social Security Act and who met the criteria in
subparagraph (A) of this paragraph immediately prior to the
person's 18th birthday.
  (g) Is a spouse of an individual receiving a category of aid
and who is living with the recipient of a category of aid, whose
needs and income are taken into account in determining the cash
needs of the recipient of a category of aid, and who is
determined by the Department of Human Services to be essential to
the well-being of the recipient of a category of aid.
  (h) Is a caretaker relative as defined in ORS 412.001 who cares
for a dependent child receiving aid granted under ORS 412.001 to
412.069 and 418.647 or is the spouse of the caretaker relative.
  (i) Is under the age of 21 years, is in a youth care center and
is one for whom a public agency of this state is assuming
financial responsibility, in whole or in part.
  (j) Is under the age of 21 years and is in an intermediate care
facility which includes institutions for persons with
developmental disabilities.
  (k) Is under the age of 22 years and is in a psychiatric
hospital.
  (L) Is under the age of 21 years and is in an independent
living situation with all or part of the maintenance cost paid by
the Department of Human Services.
  (m) Is a member of a family that received aid in the preceding
month under ORS 412.006 or 412.014 and became ineligible for aid
due to increased hours of or increased income from employment. As
long as the member of the family is employed, such families will
continue to be eligible for medical assistance for a period of at
least six calendar months beginning with the month in which such
family became ineligible for assistance due to increased hours of
employment or increased earnings.
  (n) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part.
  (o) Is an individual or is a member of a group who is required
by federal law to be included in the state's medical assistance
program in order for that program to qualify for federal funds.
  (p) Is an individual or member of a group who, subject to the
rules of the department or the Oregon Health Authority, may
optionally be included in the state's medical assistance program
under federal law and regulations concerning the availability of
federal funds for the expenses of that individual or group.
  (q) Is a pregnant woman who would be eligible for aid granted
under ORS 412.001 to 412.069 and 418.647, whether or not the
woman is eligible for cash assistance.
  (r) Except as otherwise provided in this section, is a pregnant
woman or child for whom federal financial participation is
available under Title XIX or XXI of the federal Social Security
Act.

    { - (s) Is not otherwise categorically needy and is not
eligible for care under Title XVIII of the federal Social
Security Act, but whose family income is above 100 percent of the
federal poverty level and at or below 138 percent of the federal
poverty level. - }
    { - (t) - }  { +  (s) + } Would be eligible for a category of
aid but for the receipt of qualified long term care insurance
benefits under a policy or certificate issued on or after January
1, 2008. As used in this paragraph, 'qualified long term care
insurance' means a policy or certificate of insurance as defined
in ORS 743.652 (7).
    { - (u) - }  { +  (t) + } Is eligible for the Health Care for
All Oregon Children program established in ORS 414.231.
    { - (v) - }  { +  (u) + } Is dually eligible for Medicare and
Medicaid and receiving care through a coordinated care
organization.
  (4) 'Community health worker' means an individual who:
  (a) Has expertise or experience in public health;
  (b) Works in an urban or rural community, either for pay or as
a volunteer in association with a local health care system;
  (c) To the extent practicable, shares ethnicity, language,
socioeconomic status and life experiences with the residents of
the community where the worker serves;
  (d) Assists members of the community to improve their health
and increases the capacity of the community to meet the health
care needs of its residents and achieve wellness;
  (e) Provides health education and information that is
culturally appropriate to the individuals being served;
  (f) Assists community residents in receiving the care they
need;
  (g) May give peer counseling and guidance on health behaviors;
and
  (h) May provide direct services such as first aid or blood
pressure screening.
  (5) 'Coordinated care organization' means an organization
meeting criteria adopted by the Oregon Health Authority under ORS
414.625.
  (6) 'Dually eligible for Medicare and Medicaid' means, with
respect to eligibility for enrollment in a coordinated care
organization, that an individual is eligible for health services
funded by Title XIX of the Social Security Act and is:
  (a) Eligible for or enrolled in Part A of Title XVIII of the
Social Security Act; or
  (b) Enrolled in Part B of Title XVIII of the Social Security
Act.
  (7) 'Global budget' means a total amount established
prospectively by the Oregon Health Authority to be paid to a
coordinated care organization for the delivery of, management of,
access to and quality of the health care delivered to members of
the coordinated care organization.
  (8) 'Health services' means at least so much of each of the
following as are funded by the Legislative Assembly based upon
the prioritized list of health services compiled by the Health
Evidence Review Commission under ORS 414.690:
  (a) Services required by federal law to be included in the
state's medical assistance program in order for the program to
qualify for federal funds;
  (b) Services provided by a physician as defined in ORS 677.010,
a nurse practitioner certified under ORS 678.375 or other
licensed practitioner within the scope of the practitioner's
practice as defined by state law, and ambulance services;
  (c) Prescription drugs;
  (d) Laboratory and X-ray services;
  (e) Medical equipment and supplies;
  (f) Mental health services;
  (g) Chemical dependency services;
  (h) Emergency dental services;
  (i) Nonemergency dental services;
  (j) Provider services, other than services described in
paragraphs (a) to (i), (k), (L) and (m) of this subsection,
defined by federal law that may be included in the state's
medical assistance program;
  (k) Emergency hospital services;
  (L) Outpatient hospital services; and
  (m) Inpatient hospital services.
  (9) 'Income' has the meaning given that term in ORS 411.704.
  (10) 'Investments and savings' means cash, securities as
defined in ORS 59.015, negotiable instruments as defined in ORS
73.0104 and such similar investments or savings as the department
or the authority may establish by rule that are available to the
applicant or recipient to contribute toward meeting the needs of
the applicant or recipient.
  (11) 'Medical assistance' means so much of the medical, mental
health, preventive, supportive, palliative and remedial care and
services as may be prescribed by the authority according to the
standards established pursuant to ORS 414.065, including premium
assistance and payments made for services provided under an
insurance or other contractual arrangement and money paid
directly to the recipient for the purchase of health services and
for services described in ORS 414.710.
  (12) 'Medical assistance' includes any care or services for any
individual who is a patient in a medical institution or any care
or services for any individual who has attained 65 years of age
or is under 22 years of age, and who is a patient in a private or
public institution for mental diseases. 'Medical assistance '
does not include care or services for an inmate in a nonmedical
public institution.
  (13) 'Patient centered primary care home' means a health care
team or clinic that is organized in accordance with the standards
established by the Oregon Health Authority under ORS 414.655 and
that incorporates the following core attributes:
  (a) Access to care;
  (b) Accountability to consumers and to the community;
  (c) Comprehensive whole person care;
  (d) Continuity of care;
  (e) Coordination and integration of care; and
  (f) Person and family centered care.
  (14) 'Peer wellness specialist' means an individual who is
responsible for assessing mental health service and support needs
of the individual's peers through community outreach, assisting
individuals with access to available services and resources,
addressing barriers to services and providing education and
information about available resources and mental health issues in
order to reduce stigmas and discrimination toward consumers of
mental health services and to provide direct services to assist
individuals in creating and maintaining recovery, health and
wellness.
  (15) 'Person centered care' means care that:
  (a) Reflects the individual patient's strengths and
preferences;
  (b) Reflects the clinical needs of the patient as identified
through an individualized assessment; and
  (c) Is based upon the patient's goals and will assist the
patient in achieving the goals.
  (16) 'Personal health navigator' means an individual who
provides information, assistance, tools and support to enable a
patient to make the best health care decisions in the patient's
particular circumstances and in light of the patient's needs,
lifestyle, combination of conditions and desired outcomes.
  (17) 'Quality measure' means the measures and benchmarks
identified by the authority in accordance with ORS 414.638.

  (18) 'Resources' has the meaning given that term in ORS
411.704. For eligibility purposes, 'resources' does not include
charitable contributions raised by a community to assist with
medical expenses.
  SECTION 5. ORS 414.706, as amended by section 2 of this 2013
Act, is amended to read:
  414.706. The Legislative Assembly shall approve and fund health
services to the following persons:
  (1) Persons who are categorically needy as described in ORS
414.025 (3)(o) and (p);
  (2) Pregnant women with incomes no more than 185 percent of the
federal poverty guidelines;
  (3) Persons under 19 years of age with incomes no more than 200
percent of the federal poverty guidelines; { +  and + }
  (4) Persons described in ORS 414.708 { + . + }  { - ; and - }
    { - (5) Persons 19 years of age or older with incomes above
100 percent of the federal poverty guidelines and at or below 138
percent of the federal poverty guidelines who do not have federal
Medicare coverage. - }
  SECTION 6. ORS 416.350 is amended to read:
  416.350. (1) The Department of Human Services or the Oregon
Health Authority may recover from any person the amounts of
medical assistance the department or the authority incorrectly
paid to or on behalf of the person.
  (2) Medical assistance pursuant to ORS chapter 414 paid to or
on behalf of an individual who was 55 years of age or older when
the individual received the assistance, or paid to or on behalf
of a person of any age who was a permanently institutionalized
inpatient in a nursing facility, intermediate care facility for
persons with mental retardation or other medical institution, may
be recovered from the estate of the individual or from any
recipient of property or other assets held by the individual at
the time of death including the estate of the surviving spouse.
Claim for such medical assistance correctly paid to or on behalf
of the individual may be established against the estate, but the
claim may not be adjusted or recovered until after the death of
the surviving spouse, if any, and only at a time when the
individual has no surviving child who is under 21 years of age or
who is blind or permanently and totally disabled. Transfers of
real or personal property by recipients of such aid without
adequate consideration are voidable and may be set aside under
ORS 411.620 (2).
  (3) Nothing in this section authorizes the recovery of the
amount of any aid from the estate or surviving spouse of a
recipient to the extent that the need for aid resulted from a
crime committed against the recipient.
  (4) In any action or proceeding under this section to recover
medical assistance paid, it is the legal burden of the person who
receives the property or other assets from a medical assistance
recipient to establish the extent and value of the recipient's
legal title or interest in the property or assets in accordance
with rules established by the authority.
  (5) Amounts recovered under this section do not include the
value of benefits paid to or on behalf of a beneficiary under a
qualified long term care insurance policy or certificate,
described in ORS 414.025   { - (3)(t) - }  { +  (3)(s) + }, that
were disregarded in determining eligibility for or the amount of
medical assistance provided to the beneficiary.
  (6) As used in this section, 'estate' includes all real and
personal property and other assets in which the deceased
individual had any legal title or interest at the time of death
including assets conveyed to a survivor, heir or assign of the
deceased individual through joint tenancy, tenancy in common,
survivorship, life estate, living trust or other similar
arrangement.

  SECTION 7. Section 9, chapter 736, Oregon Laws 2003, as amended
by section 2, chapter 757, Oregon Laws 2005, section 2, chapter
780, Oregon Laws 2007, section 53, chapter 828, Oregon Laws 2009,
section 19, chapter 867, Oregon Laws 2009, and section 59,
chapter 602, Oregon Laws 2011, is amended to read:
   { +  Sec. 9. + } (1) The Hospital Quality Assurance Fund is
established in the State Treasury, separate and distinct from the
General Fund. Interest earned by the Hospital Quality Assurance
Fund shall be credited to the Hospital Quality Assurance Fund.
  (2) Amounts in the Hospital Quality Assurance Fund are
continuously appropriated to the Oregon Health Authority for the
purpose of paying refunds due under section 6, chapter 736,
Oregon Laws 2003, and funding services under ORS   { - 414.705 to
414.750 - }  { + 414.631, 414.651 and 414.688 to 414.750 + },
including but not limited to:
  (a) Increasing reimbursement rates for inpatient and outpatient
hospital services under ORS   { - 414.705 to 414.750; - }
 { + 414.631, 414.651 and 414.688 to 414.750; and + }
    { - (b) Maintaining, expanding or modifying services for
persons described in ORS 414.025 (3)(s); - }
    { - (c) Maintaining or increasing the number of persons
described in ORS 414.025 (3)(s) who are enrolled in the medical
assistance program; and - }
    { - (d) - }  { +  (b) + } Paying administrative costs
incurred by the authority to administer the assessments imposed
under section 2, chapter 736, Oregon Laws 2003.
  (3) Except for assessments imposed pursuant to section 2
(3)(b), chapter 736, Oregon Laws 2003, the authority may not use
moneys from the Hospital Quality Assurance Fund to supplant,
directly or indirectly, other moneys made available to fund
services described in subsection (2) of this section.
  SECTION 8. { +  ORS 414.428 is repealed. + }
  SECTION 9.  { + The amendments to ORS 411.404, 414.025, 414.706
and 416.350 and section 9, chapter 736, Oregon Laws 2003, by
sections 3 to 7 of this 2013 Act and the repeal of ORS 414.428 by
section 8 of this 2013 Act become operative January 2, 2017. + }
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