2013 ORS § 743A.058¹
Telemedical services

(1) As used in this section:

(a) Health benefit plan has the meaning given that term in ORS 743.730 (Definitions for ORS 743.730 to 743.773).

(b) Originating site means the physical location of the patient receiving a telemedical health service.

(c) Telemedical means delivered through a two-way video communication that allows a health professional to interact with a patient who is at an originating site.

(2) A health benefit plan must provide coverage of a telemedical health service if:

(a) The plan provides coverage of the health service when provided in person by the health professional;

(b) The health service is medically necessary; and

(c) The health service does not duplicate or supplant a health service that is available to the patient in person.

(3) An originating site for a telemedical health service subject to subsection (2) of this section includes but is not limited to a:

(a) Hospital;

(b) Rural health clinic;

(c) Federally qualified health center;

(d) Physicians office;

(e) Community mental health center;

(f) Skilled nursing facility;

(g) Renal dialysis center; or

(h) Site where public health services are provided.

(4) A plan may not distinguish between originating sites that are rural and urban in providing coverage under subsection (2) of this section.

(5) A health benefit plan may subject coverage of a telemedical health service under subsection (2) of this section to all terms and conditions of the plan, including but not limited to deductible, copayment or coinsurance requirements that are applicable to coverage of a comparable health service provided in person.

(6) This section does not require a health benefit plan to reimburse a provider for a health service that is not a covered benefit under the plan or to reimburse a health professional who is not a covered provider under the plan. [2009 c.384 §2]

Note: See 743A.001 (Automatic repeal of certain statutes on individual and group health insurance).

Note: 743A.058 (Telemedical services) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.