Oregon MGMA State Chapter Legislative Update
Prepared By: Miranda Miller, Oregon MGMA State Chapter Legislative Liaison
Date: 12/30/2025
1. 2025 Legislative Updates
- Longer CCO contract horizons
- Legislation (HB 2205) and related OHA updates give the state flexibility to extend CCO contracts beyond five years, targeting stability while preserving yearly performance updates; watch for two-year extensions and evolving procurement timelines.
- The Legislature extended medical provider assessments to fund the Oregon Health Plan (OHP) and the Oregon Reinsurance Program (ORP)—aimed at stabilizing premiums and coverage in the individual market. Expect steadier OHP financing and less volatility in individual-plan premiums.
- Hospital discharge & long-term supports (SB 296)
- Directed ODHS/OHA to create eligibility dashboards and expanded Medicaid skilled nursing coverage to 100 days to speed hospital discharges for complex patients—expect operational relief on avoidable inpatient days if implemented well.
- Shield law protections & coverage compliance
- Oregon maintained strong shield law protections for providers and patients (HB 2002, 2023; updated toolkits in 2025), while state regulators reinforced gender-affirming care coverage and Reproductive Health Equity Act (RHEA) compliance
- New BH investments and Aid & Assist updates
- OHA highlights $75M new BH capacity (including child/adolescent focus) and reforms to civil commitment/Aid & Assist processes; systems should align with county contracts and access pathways to leverage funds.
- OHA’s biennial budget (~$41.9B) continues major investments in Medicaid, behavioral health, and equity initiatives, signaling near-term stability for CCO payments and statewide access priorities.
2. Legislation Effective January 1, 2026
- Pharmacist scope expansion (SB 295)
- Pharmacists are authorized to assess, diagnose, and treat certain conditions (and continue test-and-treat for COVID-19) effective Jan 1, 2026. This expands front-door access for minor illnesses and supports load-balancing across ambulatory settings.
- Rural health transformation grants
- Oregon was awarded $197.3M (beginning 2026) for rural care transformation amid expected federal Medicaid funding pressures; funds skew toward workforce, technology, and prevention (limited direct provider payments). Systems should prepare shovel-ready projects aligned to OHA priorities.
- Behavioral Health Parity: Permanent rules effective Jan. 1, 2026. DFR Parity Rules: Permanent Rules on Behavioral Health Parity.
- 340B Reform (HRSA rebate pilot starts Jan. 1, 2026; litigation pending.
3. What to Watch for in 2026
2026 Legislative Session Priorities
- Presumptive Eligibility Fix: Raise threshold to $1,500
- Hospital Staffing Bills: Unlikely to advance
- Cost Growth Target Delay: Debate over 5–10 years
- Restore Quality Incentive Payments
- Prioritized List repeal proposal for CMS compliance.
- Site Neutrality (equal payment for outpatient services)
2026: Jan/Feb Short Session; Mar 3/10 Filing dates; May Primary Elections (Gubernatorial); Nov General Elections (Gubernatorial); CCO Focus: Broad Interest Topics; Key Compliance Measures; 2027 Contract Restatements; Engagement/Landscape Scan and Gap Analysis.
2027: Jan–June 84th Legislative Session; Sep CCO Final Reviews of Procurement Documentation; Oct CCO RFA/RFP Release Date.
2028: Jan/Feb CCO 2028 RFA/RFP Responses due; Apr CCO Contract Awarded.
2029: Jan–June 85th Legislative Session; CCO 3.0 Implementation
4. Resources and Next Steps
- ONA Letter
- Rural Health Transformation Program
- Five Things to Know About Medicare Site-Neutral Payment Reforms
- What Is Site Neutrality and Could It Help Reduce Healthcare Costs?
- What Were Key 340B Developments in 2025, and What's Ahead for 2026?
- Presidential Order Calls for Major Changes to 340B, Site Neutral Payment, and Medicare Drug Prices
- Chair Cassidy Releases Report on 340B Reform, Calls for Congressional Action