Oregon Revised Statutes Chapter 414 § 414.690 — Prioritized list of health services

Prioritized list of health services. (1) The Health Evidence Review Commission shall regularly solicit testimony and information from stakeholders representing consumers, advocates, providers, carriers and employers in conducting the work of the commission. (2) The commission shall actively solicit public involvement through a public meeting process to guide health resource allocation decisions that includes, but is not limited to: (a) Providing members of the public the opportunity to provide input on the selection of any vendor that provides research and analysis to the commission; and (b) Inviting public comment on any research or analysis tool or health economic measures to be relied upon by the commission in the commission’s decision-making. (3)(a) The commission shall develop and maintain a list of health services ranked by priority, from the most important to the least important, representing the comparative benefits of each service to the population to be served. (b) Except as provided in ORS 414.701, the commission may not rely upon any quality of life in general measures, either directly or by considering research or analysis that relies on a quality of life in general measure, in determining: (A) Whether a service is cost-effective; (B) Whether a service is recommended; or (C) The value of a service. (c) The list must be submitted by the commission pursuant to subsection (5) of this section and is not subject to alteration by any other state agency. (4) In order to encourage effective and efficient medical evaluation and treatment, the commission: (a) May include clinical practice guidelines in its prioritized list of services. The commission shall actively solicit testimony and information from the medical community and the public to build a consensus on clinical practice guidelines developed by the commission. (b) May include statements of intent in its prioritized list of services. Statements of intent should give direction on coverage decisions where medical codes and clinical practice guidelines cannot convey the intent of the commission. (c) Shall consider both the clinical effectiveness and cost-effectiveness of health services, including drug therapies, in determining their relative importance using peer-reviewed medical literature. (5) The commission shall report the prioritized list of services to the Oregon Health Authority for budget determinations by July 1 of each even-numbered year. (6) The commission shall make its report during each regular session of the Legislative Assembly and shall submit a copy of its report to the Governor, the Speaker of the House of Representatives and the President of the Senate and post to the Oregon Health Authority’s website, along with a solicitation of public comment, an assessment of the impact on access to medically necessary treatment and services by persons with disabilities or chronic illnesses resulting from the commission’s prior use of any quality of life in general measures or any research or analysis that referred to or relied upon a quality of life in general measure. (7) The commission may alter the list during the interim only as follows: (a) To make technical changes to correct errors and omissions; (b) To accommodate changes due to advancements in medical technology or new data regarding health outcomes; (c) To accommodate changes to clinical practice guidelines; and (d) To add statements of intent that clarify the prioritized list. (8) If a service is deleted or added during an interim and no new funding is required, the commission shall report to the Speaker of the House of Representatives and the President of the Senate. However, if a service to be added requires increased funding to avoid discontinuing another service, the commission shall report to the Emergency Board to request the funding. (9) The prioritized list of services remains in effect for a two-year period beginning no earlier than October 1 of each odd-numbered year. (10)(a) As used in this section, “peer-reviewed medical literature” means scientific studies printed in journals or other publications that publish original manuscripts only after the manuscripts have been critically reviewed by unbiased independent experts for scientific accuracy, validity and reliability. (b) “Peer-reviewed medical literature” does not include internal publications of pharmaceutical manufacturers. [2011 c.720 §24; 2024 c.18 §3]