Or. Rev. Stat. §§ 743B.250 through 743B.258: Health Benefit Plans: Individual and Group — Grievances and Appeals – Oregon

Status: Enacted
Year Enacted: 2015
Year Amended: 2019
File: Download

Provides the process for appeal and external review. Requires an insurer to provide all information relating to benefit design and provider networks. States that an insurer must have an external review program to assess whether a course or plan of treatment is medically necessary, experimental or investigational, an active course of treatment for purposes of continuity of care, among other things. Requires contract with independent review organizations to provide external review, provides duties of independent review organizations, and private right of action. See definition section Or. Rev. Stat. § 743B.001.

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