HB 3591
Requires a group or individual health benefit plan, policy or contract, including plans offered by the Public Employees' Benefit Board or the Oregon Educators Benefit Board, to reimburse out-of-network providers the same as in-network providers for pediatric care and prohibits additional out-of-pocket costs for pediatric care.
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 requires health insurance plans, including those offered by the Public Employees’ Benefit Board and the Oregon Educators Benefit Board, to reimburse out-of-network providers for pediatric care at the same rate as in-network providers. It also prohibits additional out-of-pocket costs, such as copays or deductibles, for these services. The bill amends existing Oregon laws to clarify these requirements and apply them to specific benefit plans.
Key provisions
- Requires out-of-network providers for pediatric care to be reimbursed at the same rate as in-network providers.
- Prohibits additional out-of-pocket costs (copays, deductibles, coinsurance) for pediatric care services.
- 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 health care service contractors are considered insurers for the purposes of these regulations.
- Sets the effective date for the new requirements as the 91st day after the legislative session adjourns.
- Applies the changes to policies issued on or after January 1, 2026.
Who is affected
- Health insurance companies
- Public Employees’ Benefit Board (PEBB)
- Oregon Educators Benefit Board (OEBB)
- Pediatric care providers
- Individuals covered by health insurance plans
Notable changes
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