Rural Medical Practitioners Insurance Subsidy Program
Upcoming Changes to the Rural Medical Practitioners Insurance Subsidy Program
Oregon HB 3261 extends the Rural Medical Practitioners Insurance Subsidy Program as part of the Health Care Provider Incentive Program. The Oregon Health Authority will be holding a public hearing on proposed rules OAR 409-036 on December 18, 2017 at the Human Service Building in Salem. The Authority will be accepting written testimony prior to the hearing date. You can find details of the hearing and testimony submission here.
The affidavits for participation were sent via email to the email address on record on November 28, 2017. The deadline for the affidavits is December 31, 2017
HB 3630 (2003), SB 183 (2007), SB 608 (2011), and HB 3261 (2017)
This program is authorized by ORS 676.550-676.556
NOTE: If your malpractice coverage is provided through a health care facility and you are employed by that facility, you are not eligible to participate in this program.
A health care facility is defined in ORS 442.015 (“Health Care Facility Defined”) as a hospital, an ambulatory surgical center, a freestanding birthing center, or an outpatient renal dialysis center exclusive of a long term care facility, and includes all publicly and privately owned and operated health care facilities, but does not include facilities described in ORS 441.065 (Exemption of Certain Religious Institutions) [Formerly 441.415; 1979 c.697 §8; 1981 c.693 §15]
Is there an annual renewal?
Yes. There is an annual renewal process. ORH will automatically mail a renewal affidavit to your practice address each October. Your renewal must be received by DECEMBER 31 in order for you to continue participation in the program without a lapse in eligibility.
After I submit the affidavit, what date will my eligibility take effect?
If your practice and liability coverage meet the criteria, your eligibility will take effect the 1st day of the calendar year quarter following receipt of your affidavit. The first day of the calendar year quarters are January 1, April 1, July 1 and October 1.
Examples: If your affidavit is received March 14, your eligibility would be effective April 1. If your affidavit is received August 3, your eligibility would be effective October 1.
How long will the program be in effect?
SB 183, passed in the 2007 Oregon Legislature, extended the program through December 31, 2011.
SB 608, passed in the 2011 Oregon Legislature, extended and funded it through June 30, 2013. The bill also transfers fiscal administrative responsibilities to the Oregon Health Authority effective January 1, 2012.
The 2013 Oregon Legislature extended funding for the program through June 30, 2015.
The 2015 Oregon Legislature extended funding for the program through June 30, 2017.
The 2017 Oregon Legislature extended funding for the program through June 30, 2019.
What percentage of reimbursement might I be eligible for?
Reimbursement at the following percentages is allowed for policy limits not exceeding $1 million per occurrence and $3 million aggregate (to view all of the specific administrative guidelines, see the Rural Medical Practitioners Insurance Subsidy Program Administrative Rules above):
- 80 percent for doctors specializing in obstetrics; and
80 percent for nurse practitioners certified for obstetric care
- 60 percent for doctors specializing in family or general practice who provide obstetrical services
- Up to 40 percent for doctors and nurse practitioners engaging in one or more of the following practices:
- Family practice without obstetrics
- General practice
- Internal medicine
- Pulmonary medicine
- General surgery
- Up to 15 percent for doctors and nurse practitioners other than those included in (a), (b) or (c) above.
What happens after I submit the affidavit?
Your affidavit information is entered into a database in the Office of Rural Health (ORH). If it is determined that you are eligible for the program, the data is forwarded to the Oregon Health Authority (OHA), and you receive confirmation by email. OHA will be responsible for disbursing the funds to the participating liability carriers. If it is determined that you are not eligible for the program based on your practice location, we will notify you by email.
What will OHA do with my information?
OHA will forward your data to your liability carrier to notify them that you are eligible for the program.
What does my liability carrier do next?
If your carrier has elected to participate in the program, it is then responsible for invoicing OHA for the appropriate reimbursement amount. Your carrier can reduce the premium charged to you by either:
- deducting the subsidy from the premium you are billed, or
- crediting the subsidy to you after payment of the full premium.
This action takes place after you have paid your quarterly premium.
Note: If your coverage is provided through a health care facility, you are not an employee of that facility and you are named separately on the professional liability insurance policy that covers you, you must fully reimburse the health care facility the amount of the premium that is credited to you.
Which liability carriers have elected to participate in the program to date?
- CNA (Affinity Insurance Service, Inc – nurse practitioners only)
- CNA (Oregon Medical Association Group)
- Darwin National Assurance Company
- National Union Fire Insurance Co.
- Preferred Professional Insurance Company
- The Doctors Company
- The Medical Protective Insurance Company
- Physicians Insurance
What do I do if my liability carrier has not yet elected to participate?
Contact your carrier to determine if they intend to participate. You may only participate if your carrier chooses to participate.
I just received this quarter's or next quarter's billing from my liability carrier. Should I pay it?
Yes. Your carrier will not invoice OHA for your reimbursement until you have paid your quarterly premium.
When did the program start?
For MDs and DOs, January 1, 2004. For NPs, January 1, 2008.
Eric Jordan, Administrative Coordinator | email@example.com | 503 494-4451 | toll-free 866-674-4376.