(1) If a group health benefit plan, as described in ORS § 743B.005, 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 to 675.835 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 do not apply to this section. [2009 c.549 § 2]

743A.052 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.