NP and PA Equal Pay Webinar: Implementing HB 2902

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The Oregon Nurses Association has represented Oregon’s Nurse Practitioners since 1975 through the Nurse Practitioners of Oregon (NPO). Since that time, NPO has fought to maintain and enhance progressive and independent NP practice.

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Oregon OHSA

Workers Compensation DFCS

Finance and Corp. Securities

Building Codes Insurance Division

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The Oregon Insurance Division empowers and protects consumers through fair and efficient regulation while encouraging a financially stable, innovative, and competitive insurance marketplace.

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• OID Financial Regulations Section

• OID Licensing and Product Regulation Section

• The Consumer Advocacy Unit

• The OID Market Regulations Section

• Senior Policy Team and Administration

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• License insurance companies and monitor their ability to pay claims

• Review insurance products and premium rates

• Monitor the marketplace and the conduct of insurers

• Work with consumers to resolve

• insurance issues

• Educate the public

• Advocate for reforms

• Assist in resolving complaints

• Investigate violations of insurance law

• Help the public resolve complaints

• Develop public education materials

Toll Free (888) 877-4894

• In 2009, some Oregon insurers began cutting reimbursement rates for some NPs and PAs

• Primarily in primary care and mental health

• These cuts were often based on the type of the provider, not on outcomes

• Cuts limited patients’ access to care

• Made it difficult for providers to meet Oregonians’ primary care and mental health needs

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• Requires insurers to reimburse Nurse Practitioners and Physician Assistants in independent practice the same amount as Physicians for providing the same services in the same area.

• HB 2902 defines independent practice as a setting where an NP or PA bills insurers for diagnosis and procedures using their own name and national provider identifier

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• Establishes 13-member Task Force on Primary and Mental Health Care Reimbursement

• Directs task force to report to Legislative Assembly

• Specifies January 1, 2014 operative date for contracts renewed or entered into

• Establishes January 2, 2018 sunset date on reimbursement parity

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• Enforce the Insurance Code

• Go online and fill out a complaint form • http://www.oregon.gov/DCBS/insurance/gethelp/P

ages/fileacomplaint.aspx

• OID will investigate violations of the insurance code

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• Call OID at 1-877-4894 and speak with an advocate

• File a complaint online, by email, or mail

• Our advocates will: • Contact you with follow up questions • Contact the insurance company for a

statement/response • Communicate with all parties regarding

expectations • Educate and move towards resolution

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If an advocate believes an insurer is in error, and the insurer will not make corrections, the advocate will move the file to market surveillance.

• Deeper investigation

• Request provider contracts

• Require corrective action

• Issue administrative order

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Consumer Questions

Consumer Complaints

Resolution

1-888-877-4894

How Consumer Advocacy Works With You

• OID is not a collections agency • All clean claims must be paid within 30 days of

receiving the claim • Let us know if you are dealing with a repeat late

payer

ORS to Note: • ORS 743.911 - 30 days to pay • ORS 743.913 - Interest for unpaid or late claims • ORS 743.036 - Payment equity (HB 2902)

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