1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
House Bill 2040
Sponsored by Representative NOSSE (Presession filed.)
SUMMARY
The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject
to consideration by the Legislative Assembly. It is an editor’s brief statement of the essential features of the
measure as introduced.The statement includes a measure digest written in compliance with applicable readability
standards.
Digest: Tells DCBS and OHA to create a complaint process for health care providers. (Flesch
Readability Score: 69.9).
Establishes a complaint process for health care providers to submit complaints to the Depart-
ment of Consumer and Business Services or the Oregon Health Authority regarding health insurers
or coordinated care organizations.
Takes effect on the 91st day following adjournment sine die.
A BILL FOR AN ACT
Relating to a health care provider complaint process; and prescribing an effective date.
Be It Enacted by the People of the State of Oregon:
SECTION 1. Section 2 of this 2025 Act is added to and made a part of the Insurance Code.
SECTION 2.(1) For purposes of this section, “health insurer” means an insurer offering
a health benefit plan, a health maintenance organization or a health care services contrac-
tor.
(2) The Department of Consumer and Business Services shall establish a process for a
health care provider, as defined in ORS 192.556, to submit a complaint alleging that a health
insurer has violated a provision of the Insurance Code or rule established by the department
as authorized by the Insurance Code.
(3) The department may establish or increase any licensing or application fee imposed
on health insurers to carry out the provisions of this section. The department shall deposit
all moneys collected under this section into the Consumer and Business Services Fund cre-
ated in ORS 705.145. Any fee adopted by the department under this section must be based
on the department’s reasonable cost of administering this section.
(4) The department shall adopt rules to implement the provisions of this section.
SECTION 3. (1) The Oregon Health Authority shall establish a process for a health care
provider, as defined in ORS 192.556, to submit a complaint alleging that a coordinated care
organization, as defined in ORS 414.025, has violated a provision of ORS chapter 414 or rule
established by the authority as authorized by ORS chapter 414.
(2) The authority may impose a fee on coordinated care organizations to carry out the
provisions of this section. Any fees collected shall be paid to the Oregon Health Authority
Fund established in ORS 413.101. Any fee adopted by the authority under this section must
be based on the authority’s reasonable costs of administering this section.
(3) The authority shall adopt rules to implement the provisions of this section.
SECTION 4. Sections 2 and 3 of this 2025 Act become operative on July 1, 2026.
SECTION 5.The Department of Consumer and Business Services and the Oregon Health
NOTE:Matter in boldfaced type in an amended section is new; matter [italic and bracketed] is existing law to be omitted.
New sections are in boldfaced type.
LC 1183 HB2040
1
2
3
4
5
6
7
Authority may take any action before the operative date specified in section 4 of this 2025
Act that is necessary for the department or authority to exercise, on or after the operative
date specified in section 4 of this 2025 Act, all of the duties, functions and powers conferred
on the department and the authority by sections 2 and 3 of this 2025 Act.
SECTION 6. This 2025 Act takes effect on the 91st day after the date on which the 2025
regular session of the Eighty-third Legislative Assembly adjourns sine die.
[2]