Section 743A.264 - Disease outbreaks, epidemics and conditions of public health importance(1) As used in this section: (a) "Condition of public health importance" has the meaning given that term in ORS 431A.005.(b) "Disease outbreak" has the meaning given that term in ORS 431A.005.(c) "Enrollee" means an individual residing in this state who: (A) Is enrolled in a health benefit plan; and(B) The Public Health Director determines may be affected by a disease outbreak, epidemic or other condition of public health importance.(d) "Epidemic" has the meaning given that term in ORS 431A.005.(e) "Health benefit plan" has the meaning given that term in ORS 743B.005.(f) "Insurer" means a person with a certificate of authority to transact insurance in this state.(g) "Utilization review" has the meaning given that term in ORS 743B.001.(2) If the director determines that there exists a disease outbreak, epidemic or other condition of public health importance in a geographic area of this state or statewide, an insurer shall, for enrollees in a health benefit plan offered by the insurer, cover the cost of necessary antitoxins, serums, vaccines, immunizing agents, antibiotics, antidotes and other pharmaceutical agents, medical supplies or other prophylactic measures approved by the United States Food and Drug Administration that the director deems necessary to prevent the spread of the disease, epidemic or other condition of public health importance.(3) An insurer may not restrict coverage under subsection (2) of this section by:(a) Requiring that the health services be administered by an in-network provider;(b) Imposing cost-sharing requirements that are greater than the cost-sharing requirements for similar covered services;(c) Requiring prior authorization or other utilization review measures; or(d) Limiting coverage in any manner that prevents an enrollee from accessing the necessary health services.Amended by 2019 Ch. 284, § 7, eff. 1/1/2020. See 743A.001.
743A.264 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.