[{"_1":2,"_87":-5,"_88":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6343095,"mediaKeyId","2252862-60894cc975e57e0fb7a618b2dac236ce","parentId",2252862,"title","Committee hears bills to register, license PSAOs; supporters seek transparency, opponents warn of burdens","audioSeconds",1409,"startMs",17115,"endMs",1426930,"viewUrl","/Search/View?dp=1&key=2252862-60894cc975e57e0fb7a618b2dac236ce&start=17&end=1426","thumbnailUrl","https://assets.pipeline.soar.com/2252862-60894cc975e57e0fb7a618b2dac236ce/thumbnail_17115.jpg","articleUrl","/articles/6343095/Oregon/Committee-hears-bills-to-register-license-PSAOs-supporters-seek-transparency-opponents-warn-of-burdens","mediaUrl","https://secure.pipeline.soar.com/6343095-c17d50e5231ea4a77db3b2e5551ede70/orig.mp4?Expires=1775354935&Signature=ECCUf63uuvoVyh1MyozL~QCcjdwMwsQzriv7kBsHERDR1R65F9MVNpMq9rvz68rqwmRU~36QiyO8EjgAABYJPIDJaC5ht0nDQ7gpGB--ow40yN7LWvSUTzOCUQa~RqZ8UsxO2J3zeDjatPH8CkQ25Gjt6zy5-yE3-NWaKqiAxvlA1d~sJilohJWNVE1Se~1FZQW8HzHmikJjRQ0u9bVO~N4Xq--i~5QcTYI3IUyjpuq2Nvvhm548l7uyU-fprE4eKjZr0JXcMroTFbiUliFVR5AVmep2r6GHXMiA9SIOMnUo5KqKAUOwiyutylzansADSsZ74KsqJm~qHOLC7e89Ww__&Key-Pair-Id=KUT5TJCACFTXG","author","Oregon State Legislature","date","2025-02-06T00:00:00Z","article","The House Committee on Behavioral Health and Health Care heard competing views on legislation to bring pharmacy services administrative organizations (PSAOs) under state registration or licensing requirements, with advocates saying the measures would add transparency and opponents warning the proposals could impose burdens that raise costs for independent pharmacies.

Supporters told the committee on Feb. 6 that PSAOs, which many independent pharmacies use to handle contracting, claims submissions and appeals with pharmacy benefit managers (PBMs), are an important but under‑examined part of the drug supply chain. “House Bill 2,149 will allow the State to better examine what value and what costs PSAOs are bringing to the independent pharmacies and the drug supply chain,” Kelsey Wilson of the Pharmaceutical Care Management Association said in support of the bill.

The bills would require PSAOs to register or be licensed and to disclose affiliations and contract terms to the pharmacies they represent. Proponents, including Rep. Nancy Nathanson (sponsor) and Rep. Bobby Levy, said state registration would close a regulatory gap that can leave pharmacies unsure who negotiates on their behalf. “This bill ensures that PBMs remain subject to the laws that govern them, even when they enter into agreements with PSAOs,” Rep. Levy told the committee.

Why it matters: Committee members and advocates said the proposals are intended to make contract terms and ownership transparent so pharmacies can understand reimbursement rates, audits and clawbacks whether a contract is held directly with a pharmacy or through a PSAO. Proponents cited instances where pharmacies received payments or notices without sufficient identifying information, which complicated reconciliation and appeals.

What supporters said
- Kelsey Wilson (PCMA) said PSAOs represent the majority of independent pharmacies and called for licensing so the state can “examine what value and what costs PSAOs are bringing.” She noted data showing three large PSAOs are owned by wholesalers that control most drug distribution nationally.
- Fawn Berry of Moda Health and Dr. Regina Mendez Harper of Prime Therapeutics both said the bills would extend existing PBM rules to contracts formed through PSAOs and require PSAOs to share contracts and ownership disclosures with pharmacies. “This bill is just really trying to make sure that there's some accountability and transparency into this side of the supply chain,” Mendez Harper said.
- Sponsors and several pharmacy groups urged parity so protections enacted in earlier PBM laws apply regardless of whether a pharmacy contracts directly or via a PSAO.

Concerns and opposition
- Leah Lindahl, vice president of state government affairs for the Health Care Distribution Alliance, and Lucas Coody, director of government affairs for AlignRx (an independent PSAO), testified in respectful opposition to the bills as drafted. They said PSAOs provide voluntary, back‑office services used by independent pharmacies for an average monthly fee (witnesses described an approximate market fee of about $200) and argued registration or licensing regimes written for other entities could mischaracterize PSAO operations.
- Witnesses warned that high licensing fees or administrative burdens could be passed back to small pharmacies. AlignRx said it already shares contract and rate information with its pharmacies and urged sponsors to craft a targeted disclosure/registration approach rather than a broad licensing requirement that might force some PSAOs to stop operating in Oregon.
- Several witnesses urged workgroup negotiation to refine language. “We respectfully oppose as written,” Coody said, but added he appreciated inclusion of PSAOs in anti‑retaliation and appeals protections and offered to work with sponsors on technical fixes.

State comparisons and specifics
Representative Nathanson summarized other states' approaches during testimony: Maryland requires PSAO registration with an insurance authority; Montana enacted parity for PBMs and PSAOs in 2023; New Jersey requires PSAO registration with its Department of Banking and Insurance; Pennsylvania passed registration with a $500 fee in 2024; Mississippi was reported to be considering related disclosure requirements. Witnesses and sponsors emphasized distinctions between registration (simple notification) and full licensure (fees, annual renewals, regulatory oversight).

Unresolved items and next steps
Committee members and witnesses agreed to continue negotiations. Chair Noss suggested staff, sponsors and industry stakeholders meet to develop amendments that preserve transparency while minimizing unintended burdens on independent pharmacies. The committee closed the public hearing on House Bill 2,149 and opened an additional hearing on related language in House Bill 3,226; sponsors said both measures will be part of ongoing work to shape final PBM/PSAO reform.

Ending: The committee did not take formal action on either bill at the hearing and directed parties toward follow‑up meetings to draft compromise language ahead of future work sessions.

","mediaType","Video","parentTitle","House Committee On Behavioral Health and Health Care 02/06/2025","oneSentenceSummary","The House Committee on Behavioral Health and Health Care heard competing testimony Feb. 6 on bills that would require pharmacy services administrative organizations to register or be licensed in Oregon, with supporters saying the changes would add transparency for independent pharmacies and opponents warning new rules could raise costs or force some PSAOs out of the state.","taxTitle","Behavioral Health and Health Care, House of Representatives, Committees, Legislative, Oregon","taxId",17444,"location","Oregon","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6343090,"Officials urge six‑year extension of insurer and hospital assessments to keep Oregon reinsurance program intact",0,2295155,"/Search/View?dp=1&key=2252862-60894cc975e57e0fb7a618b2dac236ce&start=2295&end=2295","https://assets.pipeline.soar.com/2252862-60894cc975e57e0fb7a618b2dac236ce/thumbnail_2295155.jpg","/articles/6343090/Oregon/Officials-urge-sixyear-extension-of-insurer-and-hospital-assessments-to-keep-Oregon-reinsurance-program-intact","https://secure.pipeline.soar.com/6343090-64ba03491275ffe27e088dc04af271bc/orig.mp4?Expires=1775354935&Signature=fOOLnOIivJjuwYYOfqgHK-WWeIL4yYkF59aSonVS9aAvs9iz4jR~wlb-nU84zCzQyQ2WYOBPS5F3ILW~07XZbAKv1kPYlky78ODWbdnAVn5AoxMOstPRrXsNsT~iBPBKLBeIEp44-YT-NniSD7NJr3LL50Al0BCtVOmULtW6FP~7glKXL20BMJDhxEXGWb71HRZEOTJ4xbXpmTj38-zQqzgwec~lslW~U7GvU~SbasEEY0yIPxdr5~XYGSj3TDLJmB7K3OV9LdCzuLNUq4IaTs1dfLpmWHAXHK3lT3g0HmqcQVJqiulJA2XP6ybKJ5GW2SS7fWYb3ehQOdtKJfnVuA__&Key-Pair-Id=KUT5TJCACFTXG","State insurance and health officials and a broad coalition of health industry groups urged the House Committee on Behavioral Health and Health Care on Feb. 6 to extend the insurer and hospital assessments that fund Oregon's Reinsurance Program and substantial portions of the Oregon Health Plan.

Andrew Stolfi, director of the Department of Consumer and Business Services (DCBS), told the committee the reinsurance program and the insurance premium assessment were established in 2017 (House Bill 2391) and later increased and extended in 2019. “For the 2025 plan year, for example, it will reimburse insurers for 50% of their costs over an attachment point of $103,000 and up to $1,000,000 per member,” Stolfi said, describing one of the program’s cost‑containment mechanics.

Why it matters: The assessment (set at 2% since 2019) generates state funds that, together with a federal match, finance the Oregon Reinsurance Program (ORP) and other Medicaid supports. Officials said the ORP has helped stabilize the individual market, increase insurer participation and lower premiums — collectively saving Oregonians nearly $600 million in premiums over the program’s operation.

Key testimony and details
- Program history and mechanics: Stolfi traced the program from a 1.5% initial assessment in 2018 (approved by voters in a 2018 special election) to a 2% rate authorized in 2019 and extended through 2026. The ORP reimburses insurers for extreme high‑cost claims and is approved in five‑year federal waiver increments (next renewal 2027).
- OHA perspectives: Emma Sando (Medicaid director) and Rochelle Layton (OHA CFO) described Medicaid budget drivers, including caseload growth, federal match rate changes and program investments in behavioral health and services. They noted enrollment and spending patterns vary by region and cited the program’s role in preserving county‑level access to multiple insurers.
- Broad industry support: Multiple organizations — hospitals, insurers, unions and provider groups — urged extension. Mary Ann Cooper of Cambia (Regence/Blue Cross Blue Shield region) said renewing the assessment at current levels “is critical to supporting the Oregon reinsurance program and stabilizing Medicaid.” Hospital Association of Oregon, the Oregon Medical Association, unions such as SEIU, and regional CCOs testified similarly.

Budgetary and policy implications
Witnesses emphasized that assessments leverage federal matching dollars and support Medicaid without an equivalent general‑fund increase. Committee members pressed officials on tradeoffs: if the assessment is not extended, OHA said a material portion of the Medicaid budget would need replacement from general fund dollars, and staff said there are only limited quarters of assessment revenue remaining without legislative action. Officials indicated the total program draws more than a billion dollars annually in combined state and federal funds and that failure to renew would require significant budget adjustments.

Other program design points discussed
- Scope and sunset alignment: HB 2010 proposes to align sunset dates of the insurer and hospital assessments and extend the package for six years, allowing DCBS to seek a corresponding extension of the federal reinsurance waiver.
- Equilibrium and protections for rural hospitals: OHA staff described “equilibrium” mechanics that seek to draw federal funds while protecting hospitals — particularly rural type A/B hospitals — through targeted pools and enhanced payments.
- Questions from lawmakers: Members asked about changing the program’s target (for example, raising an intended net premium reduction above the current design target of 6%), the meaning of stop‑loss insurance inclusion, and whether the state retains fund balances or “rollover” dollars; agencies said adjustments are possible but would require actuarial work and fiscal decisions.

Ending: Committee members closed the public hearing and scheduled follow‑up work sessions; sponsors and agencies signaled a technical amendment to clarify administrative details and to align the IGT (intergovernmental transfer) treatment for OHSU over the extended period.","State insurance and health officials told the committee that renewing insurer and hospital assessments and the Oregon Reinsurance Program will keep premiums lower, preserve insurer participation statewide and continue federal matching funds; witnesses warned failure to extend the assessments would force substantial general‑fund offsets.","actionData","errors"]

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Committee hears bills to register, license PSAOs; supporters seek transparency, opponents warn of burdens

Officials urge six‑year extension of insurer and hospital assessments to keep Oregon reinsurance program intact