(1) Except as provided in subsection (4) of this section, any statute described in subsection (2) of this section that becomes effective on or after July 13, 1985, is repealed on the sixth anniversary of the effective date of the statute, unless the Legislative Assembly specifically provides otherwise. (2) This section governs any statute that […]
No policy of health insurance shall exclude from payment or reimbursement losses incurred by an insured for any covered service because the service was rendered at any hospital owned or operated by the State of Oregon or any state approved community mental health program or community developmental disabilities program. [Formerly 743.701; 2011 c.720 §221]
(1) As used in this section: (a) “Behavioral health assessment” means an evaluation by a behavioral health clinician, in person or using telemedicine, to determine a patient’s need for immediate crisis stabilization. (b) “Behavioral health clinician” means: (A) A licensed psychiatrist; (B) A licensed psychologist; (C) A licensed nurse practitioner with a specialty in psychiatric […]
(1) As used in this section, “health benefit plan” has the meaning given that term in ORS 743B.005. (2) Notwithstanding ORS 743.543, with respect to a health benefit plan or a Medicare supplement insurance policy that provides coverage for ambulance care and transportation, the insurer shall indemnify directly the provider of the ambulance care and […]
(1) As used in this section: (a) “Health benefit plan” has the meaning given that term in ORS 743B.005. (b) “Osteopathic physician” means a person who holds a degree of Doctor of Osteopathic Medicine and is licensed under ORS 677.100 to 677.228. (2) An insurer that offers a health benefit plan that reimburses the cost […]
(1) An individual or group health insurance policy that provides coverage for acupuncture services performed by a physician shall provide coverage for acupuncture services performed by an acupuncturist licensed under ORS 677.757 to 677.770. (2) The coverage required by subsection (1) of this section may be made subject to provisions of the policy that apply […]
Whenever any individual or group health insurance policy or blanket health insurance policy described in ORS 743.536 (3) provides for payment or reimbursement for any service within the lawful scope of service of a clinical social worker licensed under ORS 675.530: (1) The insured under the policy shall be entitled to the services of a […]
Notwithstanding any provisions of any policy of insurance covering dental health, whenever such policy provides for reimbursement for any service that is within the lawful scope of practice of a denturist, the insured under such policy shall be entitled to reimbursement for such service, whether the service is performed by a licensed dentist or a […]
Notwithstanding any provision of a policy of health insurance, whenever the policy provides for payment of a surgical service, the performance for the insured of such surgical service by any dentist acting within the scope of the dentist’s license is compensable if performance of that service by a physician acting within the scope of the […]
(1) If a policy of insurance covering dental health provides for coverage for services performed by a dentist licensed under ORS chapter 679, the policy must also cover the services when they are performed by an expanded practice dental hygienist, as defined in ORS 679.010, who has entered into a provider contract with the insurer. […]
(1) Whenever any policy of health insurance provides for reimbursement for a primary care or mental health service provided by a licensed physician, the insured under the policy is entitled to reimbursement for such service if provided by a licensed physician assistant or a licensed nurse practitioner if the service is within the lawful scope […]
Notwithstanding any provision of any policy of health insurance, whenever the policy provides for payment or reimbursement for a service that is within the lawful scope of practice of a licensed optometrist, the insurer shall provide payment or reimbursement for the service, whether the service is performed by a physician or a licensed optometrist. Unless […]
(1) An insurer may not refuse a claim solely on the ground that the claim was submitted by a physician assistant rather than by a supervising physician for the physician assistant. (2) This section is exempt from ORS 743A.001. [Formerly 743.725; 2010 c.43 §9] Note: The amendments to 743A.044 by section 17, chapter 349, Oregon […]
Whenever any provision of any individual or group health insurance policy or contract provides for payment or reimbursement for any service which is within the lawful scope of a psychologist licensed under ORS 675.010 to 675.150: (1) The insured under such policy or contract shall be free to select, and shall have direct access to, […]
Notwithstanding any provisions of a health benefit plan as defined in ORS 743B.005, whenever the plan provides for payment or reimbursement for a service that is within the lawful scope of practice of a pharmacist, the insurer: (1) May provide payment or reimbursement for the service when the service is provided by a pharmacist; and […]
(1) If a group health benefit plan, as described in ORS 743B.005, provides for coverage for services performed by a clinical social worker or nurse practitioner, the plan also must cover services provided by a professional counselor or marriage and family therapist licensed under ORS 675.715 to 675.835 when the counselor or therapist is acting […]
(1) As used in this section: (a)(A) “Audio only” means the use of audio telephone technology, permitting real-time communication between a health care provider and a patient for the purpose of diagnosis, consultation or treatment. (B) “Audio only” does not include: (i) The use of facsimile, electronic mail or text messages. (ii) The delivery of […]
As used in ORS 743A.062, “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. “Peer-reviewed medical literature” does not include internal publications of pharmaceutical manufacturers. [Formerly 743.695]
(1) As used in this section, “medical assistance program” means the state program that provides medical assistance as defined in ORS 414.025. (2) An insurance policy or contract providing coverage for a prescription drug to a resident of this state may not: (a) Exclude coverage of the drug for a particular indication solely on the […]
(1) A prescription drug benefit program, or a prescription drug benefit offered under a health benefit plan as defined in ORS 743B.005, must provide for reimbursement for up to a 90-day supply of a prescription drug dispensed by a pharmacy, as defined in ORS 689.005, if: (a) The prescription drug is covered by the program […]
