Health Insurance: Reimbursement of Claims

ORS 743A.058
Telemedical services


As used in this section:


“Health benefit plan” has the meaning given that term in ORS 743B.005 (Definitions).


“Health professional” means a person licensed, certified or registered in this state to provide health care services or supplies.


“Originating site” means the physical location of the patient.


A health benefit plan must provide coverage of a health service that is provided using synchronous two-way interactive video conferencing if:


The plan provides coverage of the health service when provided in person by a health professional;


The health service is medically necessary;


The health service is determined to be safely and effectively provided using synchronous two-way interactive video conferencing according to generally accepted health care practices and standards; and


The application and technology used to provide the health service meet all standards required by state and federal laws governing the privacy and security of protected health information.


A health benefit plan may not distinguish between rural and urban originating sites in providing coverage under subsection (2) of this section.


The coverage under subsection (2) of this section is subject to:


The terms and conditions of the health benefit plan; and


The reimbursement specified in the contract between the plan and the health professional.


This section does not require a health benefit plan to reimburse a health professional:


For a health service that is not a covered benefit under the plan; or


Who has not contracted with the plan. [2009 c.384 §2; 2015 c.340 §1; 2017 c.309 §5]
Note: See 743A.001 (Automatic repeal of certain statutes on individual and group health insurance).
Note: 743A.058 (Telemedical services) 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.


Last accessed
Jun. 26, 2021