Treatment of craniofacial anomaly
(1) As used in this section, “craniofacial anomaly” means a physical disorder identifiable at birth that affects the bony structures of the face or head, including but not limited to cleft palate, cleft lip, craniosynostosis, craniofacial microsomia and Treacher Collins syndrome.
(2) All health benefit plans, as defined in ORS 743B.005 (Definitions), providing coverage of hospital, surgical or dental services, shall provide coverage for dental and orthodontic services for the treatment of craniofacial anomalies if the services are medically necessary to restore function.
(3) This section does not require coverage for the treatment of:
(a) Developmental maxillofacial conditions that result in overbite, crossbite, malocclusion or similar developmental irregularities of the teeth; or
(b) Temporomandibular joint disorder.
(4) Coverage required by this section may be subject to copayments, deductibles and coinsurance imposed on similar services by the terms of the plan.
(5) This section does not limit or supersede any coverage required by ORS 743A.028 (Services provided by denturist), 743A.032 (Surgical services provided by dentist) or 743A.148 (Maxillofacial prosthetic services).
(6) This section is exempt from ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance). [2012 c.21 §2]
Note: 743A.150 (Treatment of craniofacial anomaly) 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.
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.