ORS 750.005
Definitions


As used in ORS 750.005 (Definitions) to 750.095 (Requirements of contract between provider and subscriber):

(1)

“Claims” means any amount incurred by the insurer covering contracted benefits.

(2)

“Complementary health services” means the following health care services:

(a)

Chiropractic as defined in ORS 684.010 (Definitions);

(b)

Naturopathic medicine as defined in ORS 685.010 (Definitions);

(c)

Massage therapy as defined in ORS 687.011 (Definitions); or

(d)

Acupuncture as defined in ORS 677.757 (Definitions for ORS 677.757 to 677.770).

(3)

“Doctor” means any person lawfully licensed or authorized by statute to render any health care services.

(4)

“Health care service contractor” means:

(a)

Any corporation that is sponsored by or otherwise intimately connected with a group of doctors licensed by this state, or by a group of hospitals licensed by this state, or both, under contracts with groups of doctors or hospitals that include conditions holding the subscriber harmless in the event of nonpayment by the health care service contract as provided in ORS 750.095 (Requirements of contract between provider and subscriber), and that accepts prepayment for health care services; or

(b)

Any person referred to in ORS 750.035 (Regulation of hospital care associations under prior law).

(5)

“Health care services” means the furnishing of medicine, medical or surgical treatment, nursing, hospital service, dental service, optometrical service, complementary health services or any or all of the enumerated services or any other necessary services of like character, whether or not contingent upon sickness or personal injury, as well as the furnishing to any person of any and all other services and goods for the purpose of preventing, alleviating, curing or healing human illness, physical disability or injury.

(6)

“Health maintenance organization” means any health care service contractor operated on a for-profit or not for-profit basis which:

(a)

Qualifies under Title XIII of the Public Health Service Act; or

(b)

Intentionally left blank —Ed.

(A)

Provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services:
(i)
Usual physician services;
(ii)
Hospitalization;
(iii)
Laboratory;
(iv)
X-ray;
(v)
Emergency and preventive services; and
(vi)
Out-of-area coverage;

(B)

Is compensated, except for copayments, for the provision of basic health care services listed in subparagraph (A) of this paragraph to enrolled participants on a predetermined periodic rate basis;

(C)

Provides physicians’ services primarily directly through physicians who are either employees or partners of such organization, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis; and

(D)

Employs the terms “health maintenance organization” or “HMO” in its name, contracts, literature or advertising media on or before July 13, 1985. [Formerly 742.010; 1973 c.515 §5; 1979 c.799 §1; 1985 c.747 §65; 1989 c.783 §4; 1991 c.958 §3; 2003 c.33 §1]

Source: Section 750.005 — Definitions, https://www.­oregonlegislature.­gov/bills_laws/ors/ors750.­html.

750.003
Purpose
750.005
Definitions
750.015
Management to include representatives of public
750.025
Restricting distribution of income
750.035
Regulation of hospital care associations under prior law
750.045
Required capitalization
750.055
Other provisions applicable to health care service contractors
750.059
Exemption of group practice maintenance organizations from reimbursement requirement for services provided by state hospital or state-approved program
750.065
Payment or reimbursement for services within scope of practice of optometrists
750.085
Offer of replacement coverage upon order of liquidation
750.095
Requirements of contract between provider and subscriber
750.301
Definitions for ORS 750.301 to 750.341
750.303
Conditions for use of multiple employer welfare arrangement
750.305
Application for certificate
750.307
Requirements for association or group
750.309
Requirements for trust
750.311
Multiple employer welfare arrangements established in another state
750.313
Issuance or refusal of certificate of multiple employer welfare arrangement
750.315
Maintenance of reserves
750.317
Board of trustees
750.318
Officers and persons appointed to act on behalf of board
750.319
Salaries
750.321
Assessment
750.323
Notice of coverage under plan
750.325
Filings by trust
750.327
Examinations
750.329
Taxation
750.331
Prohibited activities for trustee or officer
750.333
Applicable provisions of Insurance Code
750.335
Delinquency proceedings
750.337
Exclusion from membership in guaranty funds, joint underwriting associations and other pools
750.339
Liability of excess loss insurer
750.341
Requirement for multiple employer welfare arrangement to become traditional insurer
750.505
Definitions for ORS 750.505 to 750.715
750.515
Certificate of registration required
750.525
Inapplicability of ORS 750.505 to 750.715 to certain legal services
750.535
Registration requirements
750.545
Application
750.555
Issuance of certificate of registration
750.565
Duration of certificate
750.575
Grounds for suspension or revocation of certificate or refusal to issue or renew certificate
750.585
Written provider agreement with providing attorney
750.595
Membership agreement
750.605
Unfair, discriminatory or misleading provisions in agreements prohibited
750.615
Deposit to reimburse members for unearned premiums required
750.625
Paying providing attorney contingent on claims experience prohibited
750.635
Registered agent and registered office in state required
750.645
Annual report
750.655
Filing schedule of legal service rates required
750.675
Filing of provider and membership agreement with director
750.685
Indemnification insurance or bond required
750.695
ORS 750.505 to 750.715 not to affect regulation of practice of law
750.705
Application of Insurance Code
750.715
Rules
Green check means up to date. Up to date