Oregon legislation · 2026 Legislative Measures
Oregon HB4039: Relating to medical assistance; and declaring an emergency.
Status: Chaptered, April 6, 2026
Digest: The Act requires OHA to change the way it sets rates for CCOs. The Act adds steps that OHA must take before making new rules. (Flesch Readability Score: 92.6). [ Digest: The Act requires OHA to change the way it sets rates for CCOs. The Act adds steps that OHA must take before making new rules. The Act prevents OHA from taking certain costly measures until January 2, 2028. (Flesch Readability Score: 69.3). ] Requires the Oregon Health Authority to develop a transparent and data-driven process for developing capitation rates for coordinated care organizations. [ Requires the Oregon Health Policy Board to establish a process for public review of and comment on the authority's rate development process. Requires the authority to commission an independent review of the current rate development process and report back to the Legislative Assembly. ] Requires the authority to prepare a medical assistance cost impact statement before adopting rules other than procedural rules. [ Prohibits the authority from adopting a new rule, program or contractual requirement that will cost $1 million or more during a biennium. Sunsets on January 2, 2028. ] [ Imposes a three-year moratorium on the requirement for a coordinated care organization to spend a portion of the organization's annual net income or reserves on addressing health disparities and the social determinants of health. ] Declares an emergency, effective on passage.
What the bill says
From the enrolled text, March 2, 2026:
83rd OREGON LEGISLATIVE ASSEMBLY--2026 Regular Session House Bill 4039 Introduced and printed pursuant to House Rule 12.00. Presession filed (at the request of House Interim Committee on Health Care for Representative Rob Nosse for Richard Blackwell, PacificSource Health Plans) CHAPTER ................................................. Relating to medical assistance; creating new provisions; amending ORS 413.042 and 414.065; and declaring an emergency. SECTION 1. Section 2 of this 2026 Act is added to and made a part of ORS chapter 414. SECTION 2. (1) As used in this section: (a) "Base data" means the eligibility, enrollment, encounter and other data used by the Oregon Health Authority to develop capitation rates for the following year. (b) "Capitation rate" means a fixed dollar amount paid per member per month by the authority to a coordinated care organization for the provision of medical assistance to members of the coordinated care organization. (2) The authority shall establish a transparent and data-driven process for developing capitation rates. As part of the rate development process, the authority shall: (a) Reconcile the authority's base data with data submitted by coordinated care organizations and identify any adjustments that the authority makes to the base data. (b) Identify any material cost impact of changes made in a proposed contract or annual contract restatement and include that information in the report required under paragraph (e) …