Bill > HB3243

This bill establishes new regulations for billing ground ambulance services in Oregon, focusing on protecting enrollees from excessive charges. The bill defines key terms like "ground ambulance services" (medical treatment and transportation by ambulance), "established local rate" (a locally determined pricing method for ambulance services), and specifies that ground ambulance services organizations cannot bill enrollees who have already paid their in-network cost-sharing amount. Health benefit plans must reimburse ground ambulance services organizations at either the established local rate or at least 325% of the Medicare rate. The bill requires ground ambulance services organizations to submit an annual catalog of established local rates to the Department of Consumer and Business Services, which will create a public database of these rates. The legislation applies to most health benefit plans, with options for self-funded group health plans and certain public employee benefit boards to opt in. The Department of Consumer and Business Services is tasked with creating implementing rules and can impose civil penalties up to $1,000 for repeated violations. Additionally, the department must submit a report by September 15, 2026, detailing consumer complaints, new contracts, and potential effects on premium rates, with the reporting requirement set to be repealed on January 2, 2027.