Oregon Office of Rural Health

Rural Medical Practitioners Insurance Subsidy Program

Rural Medical Practitioners Insurance Subsidy Program

Established with HB 3630 (2003), continued with SB 183 (2007), SB 608 (2011), and HB 3261 (2017).

This program is authorized by ORS 676.550-676.556.

Funding and administrative rules are available and effective through December 31, 2020.

Eligibility and Affidavits

2020 Affidavits

2020 affidavits are now live as online forms, and are located under the practitioner types below.

Eligibilty

  1. Are you covered by a malpractice insurance policy that specifically names you and separately calculates your premium?

    If yes, continue to 2. If no, you are not eligible.
     

  2. Do you pay for your own policy?

    If yes, continue to 4. If no, continue to 3.
     

  3. Do you fully reimburse the health care facility for your premium?

    If yes, continue to 4. If no, you are not eligible.
     

  4. Are you a doctor of medicine or osteopathy and do you hold an active, unrestricted license to practice medicine in Oregon?

    If yes, continue to 5. If no, you are not eligible.
     

  5. Is 60 percent or more of your practice time spent in an eligible rural area?
    If yes, continue to 6. If no, continue to 5a.
     
    1. Is 60 percent or more of your practice time spent in Ashland?

      If yes, continue to 5b. If no, you are not eligible.
       

    2. Are you practicing obstetrics?

      If yes, continue to 6. If no, you are not eligible.
       

  6. Do you have an in-force policy of liability insurance with an authorized insurer participating in the program with minimum limits of coverage of $1 million per occurrence and $1 million aggregate to maximum limits of $1 million per occurrence and $3 million aggregate?

    If yes, continue to 7. If no, you are not eligible.
     

  7. Are you willing to serve patients with Medicare or Medicaid in at least the same proportion to your total number of patients as the Medicare and Medicaid populations represent to the total number of people in the eligible areas of your countyA map that represents these percentages.

    If yes, complete the affidavit. If no, you are not eligible

Affidavit

  1. Complete and submit the affidavit.
  2. You will receive confirmation at the email address you enter on the form within two weeks.

Liability carriers currently participating in the program are listed below.

Eligibility

  1. Are you covered by a malpractice insurance policy that specifically names you and separately calculates your premium?

    If yes, continue to 3. If no, you are not eligible.
     

  2. On your malpractice insurance policy, do you share limits with a physician?

    If no, continue to 4. If yes, you are not eligible.
     

  3. Do you fully reimburse the health care facility for your premium?

    If yes, continue to 5. If no, you are not eligible.
     

  4. Are you a nurse practitioner certified by the Oregon State Board of Nursing?

    If yes, continue to 6. If no, you are not eligible.
     

  5. Is 60 percent or more of your practice time spent in an eligible rural area?

    If yes, continue to 7. If no, continue to 6a.
     

    1. Is 60 percent or more of your practice time spent in Ashland?

      If yes, continue to 6b. If no, you are not eligible.
       

    2. Are you certified in obstetrical care?

      If yes, continue to 7. If no, you are not eligible.
       

  6. Do you have an in-force policy of liability insurance with an authorized insurer participating in the program with minimum limits of coverage of $1 million per occurrence and $1 million aggregate?

    If yes, continue to 8. If no, you are not eligible.
     

  7. If you are NOT employed by a licensed physician, are you willing to serve patients with Medicare or Medicaid in at least the same proportion to your total number of patients as the Medicare and Medicaid populations represent to the total number of people in the eligible areas of your countyA map that represents these percentages.

    If yes, complete the affidavit. If no, you are not eligible.

Affidavit

  1. Complete and submit the affidavit.
  2. You will receive confirmation at the email address you enter on the form within two weeks.

Liability carriers currently participating in the program are listed below.

Processing and Timelines

  • ORH will process affidavits within two weeks of date of receipt year-round. 
  • This program operates quarterly within a calendar year (January 1 | April 1 | July 1 | October 1). Affidavits received Oct. 1 - Dec. 31 will count towards the next full calendar year. Affidavits received January 1 or later will be applied to the next possible quarter.
  • After you are determined to be eligible, if you change practice sites or insurance carriers within a year, you must submit an updated affidavit ASAP to ensure continuation of coverage.
  • 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.
  • OHA will forward your data to your liability carrier to notify them that you are eligible for the program.
  • 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.

Reimbursement Percentages

Reimbursement at the following percentages is allowed for policy limits not exceeding $1 million per occurrence and $3 million aggregate:

  1. 80 percent for doctors specializing in obstetrics; and
    80 percent for nurse practitioners certified for obstetric care
     
  2. 60 percent for doctors specializing in family or general practice who provide obstetrical services
     
  3. 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
    • Geriatrics
    • Pulmonary medicine
    • Pediatrics
    • General surgery
    • Anesthesiology
  4. Up to 15 percent for doctors and nurse practitioners other than those included in one of above.

Participating Carriers

If your carrier is not on this list, contact your carrier to determine if they intend to participate. You may only participate if your carrier chooses to participate and contracts with the Oregon Health Authority to do so.

Please have your carrier contact the OHA to begin this process: 

Joe Sullivan | joseph.sullivan@dhsoha.state.or.us | 503-559-0340

Contact

insurancesubsidy@ohsu.edu | 503-494-4451 | toll-free 866-674-4376