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

As used in this section:

“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.

“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.

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.

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.