{"data":{"id":"us-or/ors-743a.140","jurisdiction":"us-or","citation":"ORS 743A.140","heading":"Bilateral cochlear implants.","body":"(1) A health benefit plan, as defined in ORS 743B.005, shall reimburse the cost of:\n      (a) Bilateral cochlear implants if medically appropriate for the treatment of hearing loss; and\n      (b) The fitting, programming and reprogramming of bilateral or unilateral cochlear implants or other assistive listening devices performed by licensed audiologists.\n      (2) For purposes of ORS 746.230, a reasonable investigation of a claim for bilateral cochlear implants must include a request to the treating surgeon for a written recommendation based on peer-reviewed medical literature and for the medical findings that support the recommendation.\n      (3) A health benefit plan shall reimburse the cost of repair and replacement parts for a cochlear implant if the repair or parts are not covered by a warranty and are necessary for the device to be functional for the user.\n      (4) A health benefit plan shall reimburse the costs described in this section when prescribed by a licensed health professional even if over-the-counter items and services are available without a prescription.\n      (5) An adverse determination on a claim for coverage under this section must include a prominent notice to the enrollee of the enrollee’s rights to file grievances and request appeals and reviews under ORS 743B.250 and must provide a toll-free telephone number or chat line for enrollees to seek assistance in contesting the denial of or limitation on coverage.\n      (6) Coverage under this section may not be subject to a deductible, except as provided in ORS 742.008.\n      (7) The provisions of this section are exempt from ORS 743A.001.","path":["18 - Financial Institutions, Insurance","56. Insurance","Chapter 743A — Health Insurance: Reimbursement of Claims"],"source_url":"https://www.oregonlegislature.gov/bills_laws/ors/ors743A.html","current_through":"2025 Edition","vintage":"","retrieved_at":"2026-09-03T23:50:17Z","sha256":"4b8e0d8b2026de72361e7acb46abf6844aa888eca223778e13ea95065b248489","source_id":"us-or","stale":false,"prev":"us-or/ors-743a.130","next":"us-or/ors-743a.141"},"notice":"GroundRules: Original legal text. Not legal advice."}