ORS 743A.148
Maxillofacial prosthetic services

(1)

The Legislative Assembly declares that all group health insurance policies providing hospital, medical or surgical expense benefits, other than limited benefit coverage, include coverage for maxillofacial prosthetic services considered necessary for adjunctive treatment.

(2)

As used in this section, “maxillofacial prosthetic services considered necessary for adjunctive treatment” means restoration and management of head and facial structures that cannot be replaced with living tissue and that are defective because of disease, trauma or birth and developmental deformities when such restoration and management are performed for the purpose of:

(a)

Controlling or eliminating infection;

(b)

Controlling or eliminating pain; or

(c)

Restoring facial configuration or functions such as speech, swallowing or chewing but not including cosmetic procedures rendered to improve on the normal range of conditions.

(3)

The coverage required by subsection (1) of this section may be made subject to provisions of the policy that apply to other benefits under the policy including, but not limited to, provisions relating to deductibles and coinsurance.

(4)

The services described in this section shall apply to individual health policies entered into or renewed on or after January 1, 1982. [Formerly 743.706; 2016 c.11 §5]

Source: Section 743A.148 — Maxillofacial prosthetic services, https://www.­oregonlegislature.­gov/bills_laws/ors/ors743A.­html.

Notes of Decisions

Under circumstances, insurance contract provision limiting coverage for dental services to expenses incurred within 90 days of accidental injury was not contrary to public policy and void but trial court erred in striking plaintiff’s allegation that 90-day limitation negated statutorily required coverage of maxillofacial prosthetic services allegedly received. Allen v. Pacific Hospital Assoc., 91 Or App 356, 757 P2d 428 (1988)

Maxillofacial prosthetic services performed for described purpose are not required to be adjunctive to independent medical condition. Blanchard v. Kaiser Foundation Health Plan, 136 Or App 466, 901 P2d 943 (1995)

743A.001
Automatic repeal of certain statutes on individual and group health insurance 743A.010
Services provided by state hospital or state approved program 743A.012
Emergency services 743A.014
Payments for ambulance care and transportation 743A.018
Services provided by osteopathic physician 743A.020
Services provided by acupuncturist 743A.024
Services provided by clinical social worker 743A.028
Services provided by denturist 743A.032
Surgical services provided by dentist 743A.034
Services provided by expanded practice dental hygienist 743A.036
Services provided by licensed nurse practitioner or licensed physician assistant 743A.040
Services provided by optometrist 743A.044
Services provided by physician assistant 743A.048
Services provided by psychologist 743A.051
Services provided by pharmacist 743A.052
Services provided by professional counselor or marriage and family therapist 743A.058
Telemedicine services 743A.060
Definition for ORS 743A.062 743A.062
Prescription drugs 743A.063
Ninety-day supply of prescription drug refills 743A.064
Prescription drugs dispensed at rural health clinics 743A.065
Early refills of prescription eye drops for treatment of glaucoma 743A.066
Contraceptives 743A.067
Reproductive health services 743A.068
Orally administered anticancer medication 743A.069
Insulin 743A.070
Nonprescription enteral formula for home use 743A.078
Newborn nurse home visiting services 743A.080
Pregnancy and childbirth expenses 743A.082
Diabetes management for pregnant women 743A.084
Unmarried women and their children 743A.088
Use by mother of diethylstilbestrol 743A.090
Natural and adopted children 743A.100
Mammograms 743A.104
Pelvic examinations and Pap smear examinations 743A.105
HPV vaccine 743A.108
Physical examination of breast 743A.110
Mastectomy-related services 743A.111
Consumer education about post-mastectomy services 743A.124
Colorectal cancer screenings and laboratory tests 743A.130
Proton beam therapy 743A.140
Bilateral cochlear implants 743A.141
Hearing aids and hearing assistive technology systems 743A.148
Maxillofacial prosthetic services 743A.150
Treatment of craniofacial anomaly 743A.160
Alcoholism treatment 743A.168
Behavioral health treatment 743A.170
Tobacco use cessation programs 743A.175
Traumatic brain injury 743A.180
Tourette Syndrome 743A.185
Telemedical health services for treatment of diabetes 743A.188
Inborn errors of metabolism 743A.190
Children with pervasive developmental disorder 743A.192
Clinical trials 743A.250
Emergency eye care services 743A.252
Child abuse assessments 743A.260
Inmates 743A.262
Preventive health services 743A.264
Disease outbreaks, epidemics and conditions of public health importance
Green check means up to date. Up to date

Current through early 2024

§ 743A.148’s source at oregon​.gov