Relating to services provided by registered nurses; and prescribing an effective date.
Summary
HB 2789 changes how certain Medicaid-related care management services can be reimbursed when they are provided by registered nurses. Under the bill, the Oregon Health Authority may not require a primary care provider’s order as a condition of payment for a covered care management service if the service is delivered by a licensed registered nurse, is within the nurse’s scope of practice, and the patient does not have a primary care provider. The bill directs OHA to create and maintain a schedule of covered services eligible for reimbursement and to establish billing and documentation rules to protect program integrity, including use of national provider identifiers by nurses seeking payment.
The bill is aimed at improving access to care management services for medical assistance recipients, especially patients who lack an established primary care provider. It effectively expands the circumstances under which registered nurses can bill Medicaid for certain services on their own authority, while still requiring OHA to define the reimbursable service list and administrative safeguards. The operative date for these changes is January 1, 2026, and the bill authorizes OHA to take preparatory action before then.
Impact
HB 2789 amends Oregon law in ORS chapter 414 by adding a new section governing Oregon Health Authority reimbursement policy for care management services provided by registered nurses to medical assistance recipients. It limits OHA’s ability to require a physician or primary care provider order in the specific circumstance described, and it requires the agency to develop reimbursement and documentation protocols. The bill affects Medicaid administration, registered nurses, and patients without primary care providers, but does not broadly alter nursing licensure or scope-of-practice law beyond relying on existing authorized scope.
Sentiment
The bill appears to have been broadly supported and noncontroversial. It passed the House committee unanimously, passed the House floor with a large bipartisan majority, and then passed the Senate committee and Senate floor unanimously. The vote pattern suggests general agreement that the bill would improve access and streamline reimbursement without creating major policy disputes.
Contention
There is little evidence of significant opposition in the available record. The only notable floor dissent was two no votes in the House third reading, but no committee transcripts or recorded debate are provided to explain the objections. The main policy issue implicit in the bill is whether Medicaid reimbursement should require a primary care provider order; supporters appear to favor removing that barrier for eligible nursing services, while any concerns would likely center on program integrity, billing oversight, and the scope of services OHA will later define through rulemaking.