Chapter 429 Oregon Laws 1999

Session Law

AN ACT

SB 588

Relating to health insurance coverage of women's health examinations; creating new provisions; amending ORS 743.727, 743.728 and 750.333; and declaring an emergency.

Be It Enacted by the People of the State of Oregon:

SECTION 1. ORS 743.727 is amended to read:

743.727. (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 coverage [upon the referral of a patient's physician, nurse practitioner or physician assistant for breast cancer screening or diagnostic purposes according to the schedule recommended under the implementation of chapter 836, Oregon Laws 1989, as incorporated into the basic health plans required to be submitted to, and authorized by, the Director of the Department of Consumer and Business Services pursuant to ORS 743.736 (1) and (2). The schedule of covered examinations required by this section shall be modified concurrently with recommended revisions to the basic health plans as approved by the director.] of mammograms as follows:

(a) Mammograms for the purpose of diagnosis in symptomatic or high-risk women at any time upon referral of the woman's health care provider; and

(b) An annual mammogram for the purpose of early detection for a woman 40 years of age or older, with or without referral from the woman's health care provider.

(2) An insurance policy described in subsection (1) of this section must not limit coverage of mammograms to the schedule provided in subsection (1) of this section if the woman is determined by her health care provider to be at high risk for breast cancer.

SECTION 2. ORS 743.728 is amended to read:

743.728. 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 required by this section, shall include coverage for pelvic examinations and Pap smear examinations [according to the schedule recommended under the implementation of chapter 836, Oregon Laws 1989, as incorporated into the basic health plans required to be submitted to and authorized by the Director of the Department of Consumer and Business Services pursuant to ORS 743.736 (1) and (2). The schedule of covered examinations required by this section shall be modified concurrently with recommended revisions to the basic health plans as approved by the director.] as follows:

(1) Annually for women 18 to 64 years of age; and

(2) At any time upon referral of the woman's health care provider.

SECTION 3. ORS 750.333 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, 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.

(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, 743.699, 743.727, 743.728, 743.730 to 743.773 (except 743.760 to 743.773), 743.804, 743.807, 743.808, 743.809, 743.814 to 743.839, 743.845 and 743.847.

(f) ORS 743.556, 743.701, 743.703, 743.704, 743.706, 743.707, 743.709, 743.710, 743.712, 743.713, 743.714, 743.717, 743.718, 743.719, 743.721, 743.722, 743.725 and 743.726. 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 agents and insurance consultants, and ORS 744.700 to 744.740.

(h) ORS 746.005 to 746.140, 746.160, 746.180 and 746.220 to 746.370.

(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.

(3) The provision of health benefits under ORS 750.301 to 750.341 shall be considered to be the transaction of health insurance.

SECTION 4. ORS 750.333, as amended by section 6, chapter 759, Oregon Laws 1997, is amended to read:

750.333. (1) The following provisions of the Insurance Code apply to trusts carrying out a multiple employer welfare arrangement:

(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.

(d) ORS 742.001 to 742.009, 742.013, 742.061 and 742.400.

(g) Provisions of ORS chapter 744 relating to the regulation of agents and insurance consultants, and ORS 744.700 to 744.740.

(h) ORS 746.005 to 746.140, 746.160, 746.180 and 746.220 to 746.370.

(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.

(3) The provision of health benefits under ORS 750.301 to 750.341 shall be considered to be the transaction of health insurance.

SECTION 5. Nothing in the amendments to ORS 750.333 by section 3 or 4 of this 1999 Act affects the repealing or operative date provisions of section 7, chapter 759, Oregon Laws 1997.

SECTION 6. This 1999 Act being necessary for the immediate preservation of the public peace, health and safety, an emergency is declared to exist, and this 1999 Act takes effect on its passage.

Approved by the Governor July 1, 1999

Filed in the office of Secretary of State July 1, 1999

Effective date July 1, 1999

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