State Law

Oregon Rev. Statutes-Title 56-Chapter 743B. Health Benefit Plans: Individual and Group

08/19/2023 Oregon Section 743B.403

Insurer prohibited practices; patient communication and referral


No insurer may terminate or otherwise financially penalize a provider for:

(1) Providing information to or communicating with a patient in a manner that is not slanderous, defamatory or intentionally inaccurate concerning:

(a) Any aspect of the patient’s medical condition;

(b) Any proposed treatment or treatment alternatives, whether covered by the insurer’s health benefit plan or not; or

(c) The provider’s general financial arrangement with the insurer.

(2)(a) Referring a patient to another provider, whether or not that provider is under contract with the insurer. If a provider refers a patient to another provider, the referring provider shall:

(A) Comply with the insurer’s written policies and procedures with respect to any such referrals; and

(B) Inform the patient that the referral services may not be covered by the insurer.

(b) Allocation of costs for referral services shall be a matter of contract between the provider and the insurer. Allocation of costs to the provider by contract shall not be considered a penalty under this section.