reglab/housing_qa huggingface dataset:
OR Rev Stat § 743A.180 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.180 - Tourette Syndrome.

For purpose of coverage by group health insurers, health care service contractors and health maintenance organizations, reimbursement for treatment of Tourette Syndrome shall be made on the basis of the diagnosis and treatment modality employed. [Formerly 743.717] Note: See 743A.001.
OR Rev Stat § 743A.185 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.185 - Telemedical health services for treatment of diabetes.

(1) As used in this section: (a) "Health benefit plan" has the meaning given that term in ORS 743B.005. (b) "Originating site" means a location where health services are provided or where the patient is receiving a telemedical health service. (c) "Telemedical" means delivered through a two-way electronic communication, including but not limited to video, audio, Voice over Internet Protocol or transmission of telemetry, that allows a health professional to interact with a patient, a parent or guardian of a patient or another health professional on a patient’s behalf, who is at an originating site. (2) A health benefit plan must provide coverage of a telemedical health service provided in connection with the treatment of diabetes if: (a) The plan provides coverage of the health service when provided in person by the health professional; (b) The health service is medically necessary; (c) The telemedical health service relates to a specific patient; and (d) One of the participants in the telemedical health service is a representative of an academic health center. (3) A health benefit plan may not distinguish between rural and urban originating sites in providing coverage under subsection (2) of this section. (4) A health benefit plan may subject coverage of a telemedical health service under subsection (2) of this section to all terms and conditions of the plan, including but not limited to deductible, copayment or coinsurance requirements that are applicable to coverage of a comparable health service when provided in person. (5) This section does not require a health benefit plan to reimburse a provider for a health service that is not a covered benefit under the plan. [2011 c.312 §2] Note: See 743A.001. Note: 743A.185 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.
OR Rev Stat § 743A.188 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.188 - Inborn errors of metabolism.

(1) All individual and group health insurance policies providing coverage for hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific diseases, shall include coverage for treatment of inborn errors of metabolism that involve amino acid, carbohydrate and fat metabolism and for which medically standard methods of diagnosis, treatment and monitoring exist, including quantification of metabolites in blood, urine or spinal fluid or enzyme or DNA confirmation in tissues. Coverage shall include expenses of diagnosing, monitoring and controlling the disorders by nutritional and medical assessment, including but not limited to clinical visits, biochemical analysis and medical foods used in the treatment of such disorders. (2) As used in this section, "medical foods" means foods that are formulated to be consumed or administered enterally under the supervision of a physician, as defined in ORS 677.010, that are specifically processed or formulated to be deficient in one or more of the nutrients present in typical nutritional counterparts, that are for the medical and nutritional management of patients with limited capacity to metabolize ordinary foodstuffs or certain nutrients contained therein or have other specific nutrient requirements as established by medical evaluation and that are essential to optimize growth, health and metabolic homeostasis. (3) This section is exempt from ORS 743A.001. [Formerly 743.726]
OR Rev Stat § 743A.250 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.250 - Emergency eye care services.

(1) As used in this section: (a) "Eye care practitioner" means an optometrist or ophthalmologist licensed by the State of Oregon. (b) "Eye care services" means health care services related to the care of the eye and related structures as specified by a health benefit plan. (c) "Health benefit plan" has the meaning provided for that term in ORS 743B.005. (2) Any insurer that offers a health benefit plan that provides coverage of eye care services shall allow any enrollee to receive covered eye care services on an emergency basis without first receiving a referral or prior authorization from a primary care provider. However, an insurer may require the enrollee to receive a referral or prior authorization from a primary care provider for any subsequent surgical procedures. Nothing in this subsection shall be construed to require that covered eye care services rendered by an eye care practitioner on an emergency basis be furnished in a hospital or similar medical facility. (3) An insurer described in subsection (2) of this section may not: (a) Impose a deductible or coinsurance for eye care services that is greater than the deductible or coinsurance imposed for other medical services under the health benefit plan. (b) Require an eye care practitioner to hold hospital privileges as a condition of participation as a provider in the health benefit plan. (4) Nothing in this section: (a) Requires an insurer to provide coverage or reimbursement of eye care services; (b) Requires an insurer to provide coverage or reimbursement of refractive surgery, ophthalmic materials, lenses, eyeglasses or other appurtenances; or (c) Prevents an enrollee from receiving eye care or other covered services from the enrollee’s primary care provider in accordance with the terms of the enrollee’s health benefit plan. (5) This section is exempt from ORS 743A.001. [Formerly 743.842] Note: 743A.250 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.
OR Rev Stat § 743A.252 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.252 - Child abuse assessments.

(1) As used in this section: (a) "Child abuse assessment" has the meaning given that term in ORS 418.782. (b) "Children’s advocacy center" has the meaning given that term in ORS 418.782. (c) "Forensic interview" has the meaning given that term in ORS 418.782. (d) "Health benefit plan" has the meaning given that term in ORS 743B.005. (2) A health benefit plan shall provide payment to or reimburse a children’s advocacy center for the services provided by the center: (a) In conducting a child abuse assessment of a child enrolled in the plan; and (b) That are related to the child abuse assessment including, but not limited to: (A) A forensic interview; and (B) Mental health treatment. (3) The payment or reimbursement made in accordance with this section must be proportionate to the scope and intensity of the services provided by the children’s advocacy center. (4) This section is exempt from ORS 743A.001. [2015 c.100 §4; 2019 c.141 §28] Note: 743A.252 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.
OR Rev Stat § 743A.262 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743A - Health Insurance: Reimbursement of Claims|Section 743A.262 - Preventive health services; cost sharing.

Notwithstanding any other provision of law, a health benefit plan that is not a grandfathered health plan: (1) Must provide coverage of preventive health services as prescribed by the United States Department of Health and Human Services pursuant to 42 U.S.C. 300gg-13 in rules adopted and in effect on January 1, 2017; and (2) May not impose cost-sharing requirements on an enrollee for preventive health services, except as allowed by federal law. [Formerly 743B.120]
OR Rev Stat § 743B.003 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.003 - Purposes.

The purposes of ORS 743.004, 743.022, 743.535, 743B.003 to 743B.127 and 743B.800 are: (1) To promote the availability of health insurance coverage to groups regardless of their enrollees’ health status or claims experience; (2) To prevent abusive rating practices; (3) To require disclosure of rating practices to purchasers of small employer and individual health benefit plans; (4) To prohibit the use of preexisting condition exclusions; (5) To encourage the availability of individual health benefit plans for individuals who are not enrolled in group health benefit plans; (6) To improve renewability and continuity of coverage for employers and covered individuals; (7) To improve the efficiency and fairness of the health insurance marketplace; and (8) To ensure that health insurance coverage in Oregon satisfies the requirements of the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191) and the Patient Protection and Affordable Care Act (P.L. 111-148) as amended by the Health Care and Education Reconciliation Act (P.L. 111-152), and that enforcement authority for those requirements is retained by the Director of the Department of Consumer and Business Services. [Formerly 743.731; 2021 c.281 §1]
OR Rev Stat § 743B.010 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.010 - Issuance of group health benefit plan to affiliated group of employers; determination of number of employees for purpose of determining eligibility as small employer.

(1) If an affiliated group of employers is treated as a single employer under section 414(b), (c), (m) or (o) of the Internal Revenue Code of 1986, a carrier may issue a single group health benefit plan to the affiliated group on the basis of the number of employees in the affiliated group if the group requests such coverage. (2) Subsequent to the issuance of a health benefit plan to a small employer, other than a plan issued through the health insurance exchange, a carrier shall determine annually the number of employees of the employer for purposes of determining the employer’s ongoing eligibility as a small employer. (3)(a) ORS 743B.010 to 743B.013 shall continue to apply to a health benefit plan issued outside of the exchange to a small employer until the plan anniversary date following the date the employer no longer meets the definition of a small employer. (b) ORS 743B.010 to 743B.013 shall continue to apply to an employer that receives coverage through the exchange until the employer no longer receives coverage through the exchange and is no longer a small employer. [Formerly 743.733]
OR Rev Stat § 743B.011 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.011 - Group health benefit plans subject to provisions of specified laws; exemptions.

(1) Except as provided in subsection (2) of this section, every health benefit plan shall be subject to the provisions of ORS 743B.010 to 743B.013, if the plan provides health benefits covering one or more employees of a small employer and if any one of the following conditions is met: (a) Any portion of the premium or benefits is paid by a small employer or any employee is reimbursed, whether through wage adjustments or otherwise, by a small employer for any portion of the health benefit plan premium; or (b) The health benefit plan is treated by the employer or any of the employees as part of a plan or program for the purposes of section 106, section 125 or section 162 of the Internal Revenue Code of 1986, as amended. (2) Subsection (1) of this section does not apply to: (a) An individual health benefit plan for which a portion of the premium is reimbursed through a qualified small employer health reimbursement arrangement as defined in section 9831 of the Internal Revenue Code; or (b) An individual health benefit plan that is considered to be integrated with a health reimbursement arrangement or other account-based group health plan authorized by federal law. (3) Except as otherwise provided by ORS 743B.010 to 743B.013 or other law, no health benefit plan offered to a small employer shall: (a) Inhibit a carrier from contracting with providers or groups of providers with respect to health care services or benefits; or (b) Impose any restriction on the ability of a carrier to negotiate with providers regarding the level or method of reimbursing care or services provided under health benefit plans. (4)(a) A carrier may provide different health benefit plans to different categories of employees of a small employer when the employer has chosen to establish different categories of employees in a manner that does not relate to the actual or expected health status of such employees or their dependents. The categories must be based on bona fide employment-based classifications that are consistent with the employer’s usual business practice. (b) Except as provided in ORS 743B.012 (7), a carrier that offers coverage to a small employer shall offer coverage to all eligible employees of the small employer. (c) If a small employer elects to offer coverage to dependents of eligible employees, the carrier shall offer coverage to all dependents of eligible employees. (5) An insurer may not deny, delay or terminate participation of an individual in a group health benefit plan or exclude coverage otherwise provided to an individual under a group health benefit plan based on a preexisting condition of the individual. [Formerly 743.734; 2017 c.152 §9; 2019 c.285 §6]
OR Rev Stat § 743B.020 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.020 - Eligible employees and small employers; rules.

(1) The Department of Consumer and Business Services shall adopt by rule a method for determining whether: (a) An employee is an eligible employee as defined in ORS 743B.005; and (b) An employer is a small employer as defined in ORS 743B.005. (2) The method adopted by the department under subsection (1) of this section must be consistent with corresponding federal requirements for the Small Business Health Options Program as defined in ORS 741.300. [2015 c.515 §3a] Note: 743B.020 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743B or any series therein. See Preface to Oregon Revised Statutes for further explanation.
OR Rev Stat § 743B.100 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.100 - Department’s authority to regulate market.

(1) In order to ensure the broadest availability of small employer and individual health benefit plans, the Department of Consumer and Business Services may approve market conduct and other requirements for carriers and insurance producers, including: (a) Registration by each carrier with the department of the carrier’s intention to offer group health benefit plans under ORS 743B.010 to 743B.013 or individual health benefit plans, or both. (b) To the extent deemed necessary by the department to ensure the fair distribution of high-risk individuals and groups among carriers, periodic reports by carriers and insurance producers concerning small employer and individual health benefit plans issued, provided that reporting requirements shall be limited to information concerning case characteristics and numbers of health benefit plans in various categories sold or issued to small employers and individuals. (c) Methods concerning periodic demonstration by carriers offering health benefit plans to individuals or small employers and insurance producers that the carriers and insurance producers are selling or issuing health benefit plans in fulfillment of the purposes of ORS 743.004, 743.022, 743.535 and 743B.003 to 743B.127. (2) The department may require carriers and insurance producers offering health benefit plans to individuals or small employers to use the open and special enrollment periods prescribed by the department by rule. [Formerly 743.745]
OR Rev Stat § 743B.102 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.102 - Certifications and disclosure of coverage.

All carriers that offer individual or group health benefit plans shall provide certifications and disclosure of coverage in accordance with 42 U.S.C. 300gg(e) and 300gg-43 as amended and in effect on July 1, 1997. [Formerly 743.749]
OR Rev Stat § 743B.103 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.103 - Use of health-related information.

(1) A carrier may not: (a) Require an applicant to provide health-related information as a precondition for the issuance of an individual health benefit plan policy; or (b) Deny coverage under an individual health benefit plan policy based on health-related information provided by the applicant. (2) A carrier may require an enrollee in a health benefit plan to complete the standard health statement prescribed by the department for the purpose of: (a) Managing the enrollee’s health care; or (b) Administering: (A) A program of health promotion or disease prevention, as described in 42 U.S.C. 300gg-4; (B) A program to promote healthy behaviors under ORS 743.824; or (C) A wellness program defined by the department by rule. [Formerly 743.751; 2021 c.281 §3]
OR Rev Stat § 743B.109 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.109 - Short term health insurance policies; rules.

(1) An insurer offering a short term health insurance policy in this state shall include in any policy document, application materials or advertisements related to the policy a notice informing an insured or prospective insured under the policy that: (a) The policy is not subject to certain federal requirements for health insurance, including requirements in the Patient Protection and Affordable Care Act (P.L. 111-148) as amended by the Health Care and Education Reconciliation Act (P.L. 111-152); (b) The insured or prospective insured should carefully review the policy documents; and (c) If the policy expires or an insured loses coverage under the policy, the insured may have to wait until the next annual open enrollment period to enroll in another policy of health insurance. (2) The Department of Consumer and Business Services may adopt rules to implement this section, including rules prescribing the form or manner of the notice described in subsection (1) of this section or any additional information that must be included in the notice. [2021 c.205 §2] Note: 743B.109 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743B or any series therein. See Preface to Oregon Revised Statutes for further explanation.
OR Rev Stat § 743B.110 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.110 - Implementation of federal laws; rules.

The Department of Consumer and Business Services may adopt rules incorporating, implementing and administering the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191), the Patient Protection and Affordable Care Act (P.L. 111-148) as amended by the Health Care and Education Reconciliation Act (P.L. 111-152) and federal regulations that are issued in conjunction with the Acts. [Formerly 743.758]
OR Rev Stat § 743B.120 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.120

[Formerly 743.764; 2017 c.152 §10; renumbered 743A.262 in 2017]
OR Rev Stat § 743B.126 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.126 - Carrier marketing of individual health benefit plans; rules; duties of carrier regarding applications; effect of discontinuing offer of plans.

(1) Each carrier shall actively market all individual health benefit plans sold by the carrier that are not grandfathered health plans. (2) Except as provided in subsection (3) of this section, no carrier or insurance producer shall, directly or indirectly, discourage an individual from filing an application for coverage because of the health status, claims experience, occupation or geographic location of the individual. (3) Subsection (2) of this section does not apply with respect to information provided by a carrier to an individual regarding the established geographic service area or a restricted network provision of a carrier. (4) Rejection by a carrier of an application for coverage shall be in writing and shall state the reason or reasons for the rejection. (5) The Director of the Department of Consumer and Business Services may establish by rule additional standards to provide for the fair marketing and broad availability of individual health benefit plans. (6) A carrier that elects to discontinue offering all of its individual health benefit plans under ORS 743B.125 (5)(c) or to discontinue both offering and renewing all such plans is prohibited from offering and renewing health benefit plans in the individual market in this state for a period of five years from the date of notice to the director pursuant to ORS 743B.125 (5)(c) or, if such notice is not provided, from the date on which the director provides notice to the carrier that the director has determined that the carrier has effectively discontinued offering individual health benefit plans in this state. This subsection does not apply with respect to a health benefit plan discontinued in a specified service area by a carrier that covers services provided only by a particular organization of health care providers or only by health care providers who are under contract with the carrier. (7) The Department of Consumer and Business Services may, in accordance with ORS 743B.129, shorten the period of prohibition described in subsection (6) of this section if necessary to ensure, in all geographic areas of this state, that: (a) A competitive health insurance market exists; (b) Consumers have a reasonable number of health insurance options available to them; and (c) Consumers who purchase insurance are protected. [Formerly 743.769; 2017 c.206 §6; 2019 c.285 §8]
OR Rev Stat § 743B.127 (2021)
2021 Oregon Revised Statutes|Volume : 18 - Financial Institutions, Insurance|Chapter 743B - Health Benefit Plans: Individual and Group|Section 743B.127 - Rules for ORS 743.022, 743B.125 and 743B.126.

The Director of the Department of Consumer and Business Services shall adopt all rules necessary for the implementation and administration of ORS 743.022, 743B.125 and 743B.126. [Formerly 743.773]