ORS 743B.287 Balance Billing Prohibited For Health Care Facility Services

• Library: Oregon Statutes
• Edition: 2023
• Currency: Current through legislation effective January 1, 2024
• Year: 2023
• Citation: ORS 743B.287

(1) As used in this section:

(a) "Emergency services" has the meaning given that term in ORS 743A.012.

(b) "Enrollee" means:

(A) An individual who is enrolled in a health benefit plan or a covered dependent or beneficiary of the individual; or

(B) A subscriber to a health care service contract or a covered dependent or beneficiary of the subscriber.

(c) "Health benefit plan" has the meaning given that term in ORS 743B.005.

(d) "Health care facility" has the meaning given that term in ORS 442.015, excluding long term care facilities.

(e) "Health care service contractor" has the meaning given that term in ORS 750.005.

(f) "In-network" has the meaning given that term in ORS 743B.280.

(g) "Out-of-network" means a provider or provider group that has not contracted or has indirectly contracted with the insurer or health care service contractor.

(2) A provider who is an out-of-network provider may not bill an enrollee in the health benefit plan or health care service contract for emergency services or other inpatient or outpatient services provided at an in-network health care facility.