ORS 743.859¹
Inclusion of statements regarding external review in health benefit plans

(1) An insurer of a health benefit plan shall include in the plan the following statements, in boldfaced type or otherwise emphasized:

(a) A statement of the right of enrollees to apply for external review by an independent review organization; and

(b) A statement of whether the insurer agrees to be bound by decisions of independent review organizations.

(2) If an insurer states in the health benefit plan as provided in subsection (1) of this section that the insurer is not bound by the decisions of independent review organizations, the plan and the written information provided by the plan must prominently disclose that:

(a) The insurer is not bound by the decisions of independent review organizations;

(b) The insurer may follow nonetheless a decision by an independent review organization; and

(c) If the insurer does not follow a decision of an independent review organization, the enrollee has the right to sue the insurer.

(3) If an insurer states in the health benefit plan as provided in subsection (1) of this section that the insurer is bound by the decisions of independent review organizations, the plan must prominently disclose that fact. The plan must also state that the insurer agrees to act in accordance with the decision of the independent review organization notwithstanding the definition of medical necessity in the plan. [2001 c.266 §10]

1 Legislative Counsel Committee, CHAPTER 743—Health and Life Insurance, https://­www.­oregonlegislature.­gov/­bills_laws/­Archive/­2007ors743.­pdf (2007) (last ac­cessed Feb. 12, 2009).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent. Currency Information