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Oregon · Through 2025 Edition

ORS 743B.288: Balance billing prohibited for labor and delivery services rendered by out-of-network provider to which insured was diverted during public health emergency.

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Where this section sits in the code
  1. 18 - Financial Institutions, Insurance
  2. 56. Insurance
  3. Chapter 743B — Health Benefit Plans: Individual and Group

(1) As used in this section:

      (a) “In-network provider” means an individual or facility that contracts with a health benefit plan or health care service contractor to provide health care services to an individual insured under the health benefit plan or health care service contract.

      (b) “Out-of-network provider” means an individual or facility that does not contract with a health benefit plan or health care service contractor to provide health care services to an individual insured under the health benefit plan or health care service contract.

      (2) An out-of-network provider that is licensed or certified in this state may not bill an individual insured under a health benefit plan or a health care service contract for the costs of labor or delivery services provided by the out-of-network provider if the services are provided by the out-of-network provider due solely to the diversion of the individual from an in-network provider during a state or federally declared public health emergency.

      (3) Subsection (2) of this section does not prohibit any provider from billing an individual insured under a health benefit plan or health care service contract for coinsurance, copayments or deductibles applicable to labor and delivery services provided by in-network providers under the terms of the health benefit plan or health care service contract.

Collected 2026-09-03T23:50:17Z. Source file · JSON

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