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State Legislation: Bill Amendments · April 6, 2026 · Primary source

OR HB 4039: new version, Enrolled

Score 80PRIMARYregulatoryState legislature

Summary

Oregon HB 4039 was signed into law on March 31, 2026, and took effect the same day as Chapter 32 of the 2026 Oregon Laws. The enacted law requires the Oregon Health Authority to develop a transparent, data-driven capitation rate-setting process for coordinated care organizations (CCOs) and mandates an independent review of the current process with a report to the Legislative Assembly. It prohibits the Authority from adopting any new rule, program, or contractual requirement costing $1 million or more per biennium (sunsetting January 2, 2028), and imposes a three-year moratorium on the requirement that CCOs spend a portion of net income or reserves on health disparities and social determinants of health.

What this may mean

CCOs operating under Oregon Medicaid contracts are immediately relieved of the health-disparities spending obligation for three years. The Oregon Health Authority faces a hard cap prohibiting new rules or contractual requirements costing $1 million or more per biennium through January 2028, and must commission an independent capitation rate review. These constraints directly affect managed care contracting terms, rate negotiation dynamics, and any pending regulatory expansions within Oregon Medicaid.

Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.

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