Oregon Statutes - Chapter 743A - Health Insurance: Required Reimbursements
- 743A.001 Automatic repeal of certain statutes on individual and group health insurance.
(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...
- 743A.010 Services provided by state hospital or state approved program.
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...
- 743A.012 Emergency services.
(1) All insurers offering a health benefit plan shall provide coverage without prior authorization for: (a) Emergency medical screening exams; (b) Stabilization of an emergency...
- 743A.014 Payments for ambulance care and transportation.
Any insurance policy issued or issued for delivery in this state that provides coverage for ambulance care and transportation shall provide that payments will be...
- 743A.020 Services provided by acupuncturist.
(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...
- 743A.024 Services provided by clinical social worker.
Whenever any individual or group health insurance policy or blanket health insurance policy described in ORS 743.534 (3) provides for payment or reimbursement for any...
- 743A.028 Services provided by denturist.
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...
- 743A.032 Surgical services provided by dentist.
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...
- 743A.036 Services provided by nurse practitioner.
(1) Whenever any policy of health insurance provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed...
- 743A.040 Services provided by optometrist.
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...
- 743A.044 Services provided by physician assistant.
(1) An insurer may not refuse a claim solely on the ground that the claim was submitted by a physician assistant rather than by the...
- 743A.048 Services provided by psychologist.
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...
- 743A.050 Services provided by registered nurse first assistant.
(1) An insurer offering a health insurance policy that provides coverage for hospital, medical or surgical expenses, other than coverage limited to expenses from accidents...
- 743A.060 Definition for ORS 743A.062.
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...
- 743A.062 Prescription drugs.
(1) No insurance policy or contract providing coverage for a prescription drug to a resident of this state shall exclude coverage of that drug for...
- 743A.064 Prescription drugs dispensed at rural health clinics.
(1) All health insurance policies that provide a prescription drug benefit, except those policies in which coverage is limited to expenses from accidents or specific...
- 743A.066 Contraceptives.
(1) A prescription drug benefit program, or a prescription drug benefit offered under a health benefit plan as defined in ORS 743.730 or under a...
- 743A.068 Orally administered anticancer medication.
(1) A health benefit plan that provides coverage for cancer chemotherapy treatment must provide coverage for a prescribed, orally administered anticancer medication used to kill...
- 743A.070 Nonprescription enteral formula for home use.
(1) All policies providing health insurance, as defined in ORS 731.162, except those policies whose coverage is limited to expenses from accidents or specific diseases...
- 743A.080 Pregnancy and childbirth expenses.
All health benefit plans as defined in ORS 743.730 must provide payment or reimbursement for expenses associated with pregnancy care, as defined by ORS 743.845,...
- 743A.084 Unmarried women and their children.
Each policy of health insurance shall provide: (1) The same payments for costs of maternity to unmarried women that it provides to married women, including...
- 743A.088 Use by mother of diethylstilbestrol.
No policy of health insurance may be denied or canceled by the insurer solely because the mother of the insured used drugs containing diethylstilbestrol prior...
- 743A.090 Newly born and adopted children.
(1) All individual and group health insurance policies providing hospital, medical or surgical expense benefits that include coverage for a family member of the insured...
- 743A.100 Mammogram.
(1) Every health insurance policy that covers hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific diseases, shall provide...
- 743A.104 Pelvic examinations and Pap smear examinations.
All policies providing health insurance, except those policies whose coverage is limited to expenses from accidents or specific diseases that are unrelated to the coverage...
- 743A.108 Physical examination of breast.
(1) A health insurance policy that covers hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific diseases, shall provide...
- 743A.110 Mastectomy-related services.
(1) All insurers offering a health benefit plan as defined in ORS 743.730 shall provide payment, coverage or reimbursement for the following mastectomy-related services as...
- 743A.120 Prostate screening examinations.
(1) An insurer offering a health insurance policy that covers hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific...
- 743A.124 Colorectal cancer screenings and laboratory tests.
(1) An insurer offering a health insurance policy that covers hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific...
- 743A.140 Bilateral cochlear implants.
(1) Whenever any policy of health insurance provides for reimbursement of a cochlear implant, the insured under the policy is entitled to coverage of bilateral...
- 743A.144 Prosthetic and orthotic devices.
(1) All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses shall include coverage for prosthetic and orthotic devices that...
- 743A.148 Maxillofacial prosthetic services.
(1) The Legislative Assembly declares that all group health insurance policies providing hospital, medical or surgical expense benefits include coverage for maxillofacial prosthetic services considered...
- 743A.160 Alcoholism treatment.
A health insurance policy providing coverage for hospital or medical expenses not limited to expenses from accidents or specified sicknesses shall provide, at the request...
- 743A.164 Injuries resulting from alcohol and controlled substances.
A health insurance policy other than a disability income policy shall provide coverage or reimbursement of expenses for the medical treatment of injuries or illnesses...
- 743A.168 Treatment of chemical dependency, including alcoholism, and mental or nervous conditions; rules.
A group health insurance policy providing coverage for hospital or medical expenses shall provide coverage for expenses arising from treatment for chemical dependency, including alcoholism,...
- 743A.180 Tourette Syndrome.
For purpose of coverage by group health insurers, health care service contractors and health maintenance organizations, reimbursement for treatment of Tourette Syndrome shall be made...
- 743A.184 Diabetes self-management programs.
(1) Subject to other terms, conditions and benefits in the plan, group health benefit plans as described in ORS 743.730 shall provide payment, coverage or...
- 743A.188 Inborn errors of metabolism.
(1) All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or...
- 743A.190 Children with pervasive developmental disorder.
(1) A health benefit plan, as defined in ORS 743.730, must cover for a child enrolled in the plan who is under 18 years of...
Last modified: August 7, 2008