75th OREGON LEGISLATIVE ASSEMBLY--2009 Regular Session
Enrolled
Senate Bill 24
Printed pursuant to Senate Interim Rule 213.28 by order of the
President of the Senate in conformance with presession filing
rules, indicating neither advocacy nor opposition on the part
of the President (at the request of Senate Interim Committee on
Health and Human Services)
CHAPTER ................
AN ACT
Relating to health benefit plan coverage of telemedical services;
creating new provisions; and amending ORS 750.055 and 750.333.
Be It Enacted by the People of the State of Oregon:
SECTION 1. { + Section 2 of this 2009 Act is added to and made
a part of the Insurance Code. + }
SECTION 2. { + (1) As used in this section:
(a) 'Health benefit plan' has the meaning given that term in
ORS 743.730.
(b) 'Originating site' means the physical location of the
patient receiving a telemedical health service.
(c) 'Telemedical' means delivered through a two-way video
communication that allows a health professional to interact with
a patient who is at an originating site.
(2) A health benefit plan must provide coverage of a
telemedical health service if:
(a) The plan provides coverage of the health service when
provided in person by the health professional;
(b) The health service is medically necessary; and
(c) The health service does not duplicate or supplant a health
service that is available to the patient in person.
(3) An originating site for a telemedical health service
subject to subsection (2) of this section includes but is not
limited to a:
(a) Hospital;
(b) Rural health clinic;
(c) Federally qualified health center;
(d) Physician's office;
(e) Community mental health center;
(f) Skilled nursing facility;
(g) Renal dialysis center; or
(h) Site where public health services are provided.
(4) A plan may not distinguish between originating sites that
are rural and urban in providing coverage under subsection (2) of
this section.
(5) A health benefit plan may subject coverage of a telemedical
health service under subsection (2) of this section to all terms
and conditions of the plan, including but not limited to
deductible, copayment or coinsurance requirements that are
Enrolled Senate Bill 24 (SB 24-A) Page 1
applicable to coverage of a comparable health service provided in
person.
(6) This section does not require a health benefit plan to
reimburse a provider for a health service that is not a covered
benefit under the plan or to reimburse a health professional who
is not a covered provider under the plan. + }
SECTION 3. ORS 750.055, as amended by section 5, chapter 22,
Oregon Laws 2008, is amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.664, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184, 743A.188 and 743A.190 { + and section 2 of this 2009
Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
Enrolled Senate Bill 24 (SB 24-A) Page 2
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 4. ORS 750.055, as amended by section 7, chapter 137,
Oregon Laws 2003, section 3, chapter 263, Oregon Laws 2003,
sections 501 and 502, chapter 22, Oregon Laws 2005, sections 5
and 6, chapter 255, Oregon Laws 2005, section 5, chapter 418,
Oregon Laws 2005, section 3, chapter 128, Oregon Laws 2007,
section 9, chapter 182, Oregon Laws 2007, section 6, chapter 313,
Oregon Laws 2007, section 4, chapter 504, Oregon Laws 2007,
section 4, chapter 566, Oregon Laws 2007, section 4, chapter 872,
Oregon Laws 2007, and section 6, chapter 22, Oregon Laws 2008, is
amended to read:
750.055. (1) The following provisions of the Insurance Code
apply to health care service contractors to the extent not
inconsistent with the express provisions of ORS 750.005 to
750.095:
(a) ORS 705.137, 705.139, 731.004 to 731.150, 731.162, 731.216
to 731.362, 731.382, 731.385, 731.386, 731.390, 731.398 to
731.430, 731.428, 731.450, 731.454, 731.488, 731.504, 731.508,
731.509, 731.510, 731.511, 731.512, 731.574 to 731.620, 731.592,
731.594, 731.640 to 731.652, 731.730, 731.731, 731.735, 731.737,
731.750, 731.752, 731.804 and 731.844 to 731.992 and section 2,
chapter 22, Oregon Laws 2008.
(b) ORS 732.215, 732.220, 732.230, 732.245, 732.250, 732.320,
732.325 and 732.517 to 732.592, not including ORS 732.582.
(c) ORS 733.010 to 733.050, 733.080, 733.140 to 733.170,
733.210, 733.510 to 733.680 and 733.695 to 733.780.
(d) ORS chapter 734.
(e) ORS 742.001 to 742.009, 742.013, 742.061, 742.065, 742.150
to 742.162, 742.400, 742.520 to 742.540, 743.010, 743.013,
743.018 to 743.030, 743.050, 743.100 to 743.109, 743.402,
743.472, 743.492, 743.495, 743.498, 743.522, 743.523, 743.524,
743.526, 743.527, 743.528, 743.529, 743.549 to 743.552, 743.560,
743.600 to 743.610, 743.650 to 743.656, 743.804, 743.807,
743.808, 743.814 to 743.839, 743.842, 743.845, 743.847, 743.854,
743.856, 743.857, 743.858, 743.859, 743.861, 743.862, 743.863,
743.864, 743.911, 743.913, 743A.010, 743A.012, 743A.036,
743A.048, 743A.062, 743A.064, 743A.066, 743A.068, 743A.070,
743A.080, 743A.084, 743A.088, 743A.090, 743A.100, 743A.104,
743A.110, 743A.140, 743A.148, 743A.160, 743A.164, 743A.168,
743A.184 and 743A.190 { + and section 2 of this 2009 Act + }.
(f) The provisions of ORS chapter 744 relating to the
regulation of insurance producers.
(g) ORS 746.005 to 746.140, 746.160, 746.220 to 746.370,
746.600, 746.605, 746.607, 746.608, 746.610, 746.615, 746.625,
746.635, 746.650, 746.655, 746.660, 746.668, 746.670, 746.675,
746.680 and 746.690.
(h) ORS 743A.024, except in the case of group practice health
maintenance organizations that are federally qualified pursuant
to Title XIII of the Public Health Service Act unless the patient
is referred by a physician associated with a group practice
health maintenance organization.
(i) ORS 735.600 to 735.650.
Enrolled Senate Bill 24 (SB 24-A) Page 3
(j) ORS 743.680 to 743.689.
(k) ORS 744.700 to 744.740.
(L) ORS 743.730 to 743.773.
(m) ORS 731.485, except in the case of a group practice health
maintenance organization that is federally qualified pursuant to
Title XIII of the Public Health Service Act and that wholly owns
and operates an in-house drug outlet.
(2) For the purposes of this section, health care service
contractors shall be deemed insurers.
(3) Any for-profit health care service contractor organized
under the laws of any other state that is not governed by the
insurance laws of the other state is subject to all requirements
of ORS chapter 732.
(4) The Director of the Department of Consumer and Business
Services may, after notice and hearing, adopt reasonable rules
not inconsistent with this section and ORS 750.003, 750.005,
750.025 and 750.045 that are deemed necessary for the proper
administration of these provisions.
SECTION 5. ORS 750.333, as amended by section 7, chapter 22,
Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180, 743A.188 and 743A.190 { + and section 2 of this 2009
Act + }. Multiple employer welfare arrangements to which ORS
743.730 to 743.773 apply are subject to the sections referred to
in this paragraph only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
Enrolled Senate Bill 24 (SB 24-A) Page 4
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 6. ORS 750.333, as amended by section 4, chapter 263,
Oregon Laws 2003, section 11, chapter 182, Oregon Laws 2007,
section 8, chapter 313, Oregon Laws 2007, section 6, chapter 504,
Oregon Laws 2007, section 6, chapter 566, Oregon Laws 2007,
section 6, chapter 872, Oregon Laws 2007, and section 8, chapter
22, Oregon Laws 2008, is amended to read:
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.044, 743A.048, 743A.066, 743A.068,
743A.084, 743A.088, 743A.090, 743A.140, 743A.148, 743A.168,
743A.180 and 743A.190 { + and section 2 of this 2009 Act + }.
Multiple employer welfare arrangements to which ORS 743.730 to
743.773 apply are subject to the sections referred to in this
paragraph only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 7. ORS 750.333, as amended by section 8, chapter 137,
Oregon Laws 2003, section 4, chapter 263, Oregon Laws 2003,
section 3, chapter 446, Oregon Laws 2003, section 6, chapter 418,
Oregon Laws 2005, section 12, chapter 182, Oregon Laws 2007,
section 9, chapter 313, Oregon Laws 2007, section 7, chapter 504,
Oregon Laws 2007, section 7, chapter 566, Oregon Laws 2007,
section 7, chapter 872, Oregon Laws 2007, and section 9, chapter
22, Oregon Laws 2008, is amended to read:
Enrolled Senate Bill 24 (SB 24-A) Page 5
750.333. (1) The following provisions of the Insurance Code
apply to trusts carrying out a multiple employer welfare
arrangement:
(a) ORS 731.004 to 731.150, 731.162, 731.216 to 731.268,
731.296 to 731.316, 731.324, 731.328, 731.378, 731.386, 731.390,
731.398, 731.406, 731.410, 731.414, 731.418 to 731.434, 731.454,
731.484, 731.486, 731.488, 731.512, 731.574 to 731.620, 731.640
to 731.652 and 731.804 to 731.992.
(b) ORS 733.010 to 733.050, 733.140 to 733.170, 733.210,
733.510 to 733.680 and 733.695 to 733.780.
(c) ORS chapter 734.
(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.
(e) ORS 743.028, 743.053, 743.524, 743.526, 743.527, 743.528,
743.529, 743.530, 743.560, 743.562, 743.600, 743.601, 743.602,
743.610, 743.730 to 743.773 (except 743.760 to 743.773), 743.801,
743.804, 743.807, 743.808, 743.814 to 743.839, 743.842, 743.845,
743.847, 743.854, 743.856, 743.857, 743.858, 743.859, 743.861,
743.862, 743.863, 743.864, 743A.012, 743A.064, 743A.080,
743A.100, 743A.104, 743A.110 and 743A.184.
(f) ORS 743A.010, 743A.014, 743A.024, 743A.028, 743A.032,
743A.036, 743A.040, 743A.048, 743A.066, 743A.068, 743A.084,
743A.088, 743A.090, 743A.140, 743A.148, 743A.168, 743A.180 and
743A.190 { + and section 2 of this 2009 Act + }. Multiple
employer welfare arrangements to which ORS 743.730 to 743.773
apply are subject to the sections referred to in this paragraph
only as provided in ORS 743.730 to 743.773.
(g) Provisions of ORS chapter 744 relating to the regulation of
insurance producers and insurance consultants, and ORS 744.700 to
744.740.
(h) ORS 746.005 to 746.140, 746.160 and 746.220 to 746.370.
(i) ORS 731.592 and 731.594.
(j) Section 2, chapter 22, Oregon Laws 2008.
(2) For the purposes of this section:
(a) A trust carrying out a multiple employer welfare
arrangement shall be considered an insurer.
(b) References to certificates of authority shall be considered
references to certificates of multiple employer welfare
arrangement.
(c) Contributions shall be considered premiums.
(3) The provision of health benefits under ORS 750.301 to
750.341 shall be considered to be the transaction of health
insurance.
SECTION 8. { + Section 2 of this 2009 Act and the amendments
to ORS 750.055 and 750.333 by sections 3 to 7 of this 2009 Act
apply to health benefit plans contracted for or renewed on or
after the effective date of this 2009 Act. + }
----------
Enrolled Senate Bill 24 (SB 24-A) Page 6
Passed by Senate April 7, 2009
...........................................................
Secretary of Senate
...........................................................
President of Senate
Passed by House June 3, 2009
...........................................................
Speaker of House
Enrolled Senate Bill 24 (SB 24-A) Page 7
Received by Governor:
......M.,............., 2009
Approved:
......M.,............., 2009
...........................................................
Governor
Filed in Office of Secretary of State:
......M.,............., 2009
...........................................................
Secretary of State
Enrolled Senate Bill 24 (SB 24-A) Page 8