Oregon Statutes 414.066 – Billing patient for services covered by medical assistance prohibited
(1) A health care provider may not bill or solicit payment from a medical assistance applicant or recipient for services, except for copayments or other charges authorized by the Oregon Health Authority by rule.
Terms Used In Oregon Statutes 414.066
- Coordinated care organization: means an organization meeting criteria adopted by the Oregon Health Authority under ORS § 414. See Oregon Statutes 414.025
- Medical assistance: includes any care or services for any individual who is a patient in a medical institution or any care or services for any individual who has attained 65 years of age or is under 22 years of age, and who is a patient in a private or public institution for mental diseases. See Oregon Statutes 414.025
(2)(a) A health care provider that submits a claim for payment to the authority or a coordinated care organization shall wait to receive payment for at least 90 days after submitting the claim before assigning the claim to a collection agency or similar entity to recover from the patient.
(b) If the claim remains unpaid 90 days after a health care provider submits the claim to the authority or a coordinated care organization, the health care provider shall first query the medical assistance program database to confirm the patient’s eligibility for medical assistance.
(c) The health care provider may not assign the claim for collection if the authority confirms that the patient was eligible for medical assistance at the time the services were provided. [2017 c.287 § 2]