Oregon Statutes 743B.403 – Insurer prohibited practices; patient communication and referral
No insurer may terminate or otherwise financially penalize a provider for:
Terms Used In Oregon Statutes 743B.403
- Contract: A legal written agreement that becomes binding when signed.
(1) Providing information to or communicating with a patient in a manner that is not slanderous, defamatory or intentionally inaccurate concerning:
(a) Any aspect of the patient’s medical condition;
(b) Any proposed treatment or treatment alternatives, whether covered by the insurer’s health benefit plan or not; or
(c) The provider’s general financial arrangement with the insurer.
(2)(a) Referring a patient to another provider, whether or not that provider is under contract with the insurer. If a provider refers a patient to another provider, the referring provider shall:
(A) Comply with the insurer’s written policies and procedures with respect to any such referrals; and
(B) Inform the patient that the referral services may not be covered by the insurer.
(b) Allocation of costs for referral services shall be a matter of contract between the provider and the insurer. Allocation of costs to the provider by contract shall not be considered a penalty under this section. [Formerly 743.834]