Section 743A.264 – Disease outbreaks, epidemics and conditions of public health importance.
(1) As used in this section: (a) “Condition of public health importance” has the meaning given that term in ORS 431A.005. (b) “Disease outbreak” has the meaning given that term in ORS 431A.005. (c) “Enrollee” means an individual residing in this state who: (A) Is enrolled in a health benefit plan; and (B) The Public […]
Section 743A.140 – Bilateral cochlear implants.
(1) A health benefit plan, as defined in ORS 743B.005, shall reimburse the cost of: (a) Bilateral cochlear implants if medically appropriate for the treatment of hearing loss; and (b) Programming and reprogramming cochlear implants. (2) For purposes of ORS 746.230, a reasonable investigation of a claim for bilateral cochlear implants must include a request […]
Section 743A.262 – Preventive health services; cost sharing.
Notwithstanding any other provision of law, a health benefit plan that is not a grandfathered health plan: (1) Must provide coverage of preventive health services as prescribed by the United States Department of Health and Human Services pursuant to 42 U.S.C. 300gg-13 in rules adopted and in effect on January 1, 2017; and (2) May […]
Section 743A.141 – Hearing aids and hearing assistive technology systems.
(1) As used in this section: (a) “Hearing aid” means any nondisposable, wearable instrument or device designed to aid or compensate for impaired human hearing and any necessary ear mold, part, attachments or accessory for the instrument or device, except batteries and cords. (b) “Hearing assistive technology systems” means devices used with or without hearing […]
Section 743A.148 – Maxillofacial prosthetic services.
(1) The Legislative Assembly declares that all group health insurance policies providing hospital, medical or surgical expense benefits, other than limited benefit coverage, include coverage for maxillofacial prosthetic services considered necessary for adjunctive treatment. (2) As used in this section, “maxillofacial prosthetic services considered necessary for adjunctive treatment” means restoration and management of head and […]
Section 743A.150 – Treatment of craniofacial anomaly.
(1) As used in this section, “craniofacial anomaly” means a physical disorder identifiable at birth that affects the bony structures of the face or head, including but not limited to cleft palate, cleft lip, craniosynostosis, craniofacial microsomia and Treacher Collins syndrome. (2) All health benefit plans, as defined in ORS 743B.005, providing coverage of hospital, […]
Section 743A.160 – Alcoholism treatment.
A health insurance policy providing coverage for hospital or medical expenses, other than limited benefit coverage, shall provide, at the request of the applicant, coverage for expenses arising from treatment for alcoholism. The following conditions apply to the requirement for such coverage: (1) The applicant shall be informed of the applicant’s option to request this […]
Section 743A.168 – Behavioral health treatment; qualified providers; rules.
(1) As used in this section: (a) “Behavioral health assessment” means an evaluation by a provider, in person or using telemedicine, to determine a patient’s need for behavioral health treatment. (b) “Behavioral health condition” has the meaning prescribed by rule by the Department of Consumer and Business Services. (c) “Behavioral health crisis” means a disruption […]
Section 743A.170 – Tobacco use cessation programs.
(1) A health benefit plan as defined in ORS 743B.005 must provide payment, coverage or reimbursement of at least $500 for a tobacco use cessation program for a person enrolled in the plan who is 15 years of age or older. (2) As used in this section, “tobacco use cessation program” means a program recommended […]
Section 743A.175 – Traumatic brain injury.
(1) A health benefit plan, as defined in ORS 743B.005, shall provide coverage of medically necessary therapy and services for the treatment of traumatic brain injury. (2) This section is exempt from ORS 743A.001. [2009 c.423 §2]