HB 3590
Prohibits out-of-network providers from balance billing for pediatric care in certain circumstances.
Jurisdiction
Oregon
Session
2025 Regular Session
Committee
Behavioral Health and Health Care
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Sign in to take action- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill aims to protect young patients by limiting out-of-network providers’ ability to balance bill for pediatric care. It requires insurers, the Oregon Educators Benefit Board, and the Public Employees’ Benefit Board to reimburse out-of-network providers for pediatric services at the same rate as in-network providers, provided no in-network option is available within a 60-mile radius. The bill also establishes a good-faith negotiation requirement for reimbursement rates.
Key provisions
- Requires insurers, OEBB, and PEBB to reimburse out-of-network providers for pediatric care at in-network rates when no in-network provider is available within 60 miles.
- Mandates good-faith negotiation of reimbursement rates between insurers and out-of-network providers.
- Defines ‘pediatric care’ as health care for children from birth to 18 years old.
- Amends ORS 243.144, 243.877, 750.055 and 750.333 to align with the new requirements.
- Specifies that the bill takes effect 91 days after it passes.
- Exempts certain health care service contractors from specific requirements.
- Addresses the classification of health care service contractors for debtor purposes.
- Establishes a date for the bill's effective date.
Who is affected
- Pediatric patients and their families
- Out-of-network healthcare providers
- Health insurance companies (including OEBB and PEBB)
- Group health insurers
- Oregon residents
Notable changes
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