ORS 442.385
Definitions
(1)
“Health care” means items, services and supplies intended to improve or maintain human function or treat or ameliorate pain, disease, condition or injury, including but not limited to the following types of services:(a)
Medical;(b)
Behavioral;(c)
Substance use disorder;(d)
Mental health;(e)
Surgical;(f)
Optometric;(g)
Dental;(h)
Podiatric;(i)
Chiropractic;(j)
Psychiatric;(k)
Pharmaceutical;(L)
Therapeutic;(m)
Preventive;(n)
Rehabilitative;(o)
Supportive; or(p)
Geriatric.(2)
“Health care cost growth” means the annual percentage change in total health expenditures in this state.(3)
“Health care entity” means a payer or a provider.(4)
“Health insurance” has the meaning given that term in ORS 731.162 (“Health insurance.”).(5)
“Net cost of private health insurance” means the difference between health insurance premiums received by a payer and the claims for the cost of health care paid by the payer under a policy or certificate of health insurance.(6)
“Payer” means:(a)
An insurer offering a policy or certificate of health insurance or a health benefit plan as defined in ORS 743B.005 (Definitions);(b)
A publicly funded health care program, including but not limited to Medicaid, Medicare and the State Children’s Health Insurance Program;(c)
A third party administrator; and(d)
Any other public or private entity, other than an individual, that pays or reimburses the cost for the provision of health care.(7)
“Provider” means an individual, organization or business entity that provides health care.(8)
Intentionally left blank —Ed.(a)
“Total health expenditures” means all health care expenditures on behalf of residents of this state by public and private sources, including:(A)
All payments on providers’ claims for reimbursement of the cost of health care provided;(B)
All payments to providers other than payments described in subparagraph (A) of this paragraph;(C)
All cost-sharing paid by residents of this state, including but not limited to copayments, deductibles and coinsurance; and(D)
The net cost of private health insurance.(b)
“Total health expenditures” may include expenditures for care provided to out-of-state residents by in-state providers to the extent practicable. [2019 c.560 §1; 2021 c.51 §1]
Source:
Section 442.385 — Definitions, https://www.oregonlegislature.gov/bills_laws/ors/ors442.html.
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