2015 ORS 743A.052¹
Services provided by professional counselor or marriage and family therapist

(1) If a group health benefit plan, as described in ORS 743B.005 (Definitions), provides for coverage for services performed by a clinical social worker or nurse practitioner, the plan also must cover services provided by a professional counselor or marriage and family therapist licensed under ORS 675.715 (Application) to 675.835 (Injunctive proceedings) when the counselor or therapist is acting within the counselor’s or therapist’s lawful scope of practice.

(2) Health maintenance organizations may limit the receipt of covered services performed by professional counselors and marriage and family therapists to services provided by or upon referral by providers contracting with the health maintenance organization. Health maintenance organizations and health care service contractors may create substantive plan benefit and reimbursement differentials at the same level as, and subject to limitations not more restrictive than, those imposed on coverage or reimbursement of expenses arising out of other medical conditions and apply them to contracting and noncontracting providers.

(3) The provisions of ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance) do not apply to this section. [2009 c.549 §2]

Note: 743A.052 (Services provided by professional counselor or marriage and family therapist) 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.


1 Legislative Counsel Committee, CHAPTER 743A—Health Insurance: Reimbursement of Claims, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors743A.­html (2015) (last ac­cessed Jul. 16, 2016).
 
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.