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83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
A-Engrossed
House Bill 3243
Ordered by the House April 16
Including House Amendments dated April 16
Sponsored by Representative NOSSE; Representatives JAVADI, PHAM H, Senator PATTERSON (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. The statement includes a measure digest written in compliance with applicable readability standards.
Digest: Tells ambulance service providers not to balance bill some patients and makes
them report local rates to DCBS. Makes some rules about health insurance for ambulance
services. Tells DCBS to make a new database of local rates and allows for penalties. Tells
DCBS to submit a report. (Flesch Readability Score: 63.5).
[Digest: Tells ambulance service providers not to balance bill some patients and makes them report
local rates to DCBS.Makes some rules about health insurance for ambulance services.Tells DCBS
to make a new database of local rates and allows for penalties. (Flesch Readability Score: 60.9).]
Prohibits balance billing for ambulance ground transportation services in certain circum-
stances and creates rules for health benefit plan [coverage] reimbursement of ambulance services.
Requires ground ambulance services to submit established local rates to the Department of
Consumer and Business Services. Establishes a database of local rates for ambulance services and
allows for penalties to be imposed for violations. Requires the department to submit a report
on the implementation of this Act.
A BILL FOR AN ACT
Relating to billing for ground ambulance services.
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) As used in this section:
(a) “Enrollee” has the meaning given that term in ORS 743B.005.
(b) “Established local rate” means the rate established where the health care services
originated for the provision of ground ambulance services through a publicly accessible pro-
cess that includes an analysis of the cost to provide the ground ambulance services by:
(A) The local government entity if the ground ambulance services are provided by ground
ambulance services organizations that are owned or operated by the local government entity;
or
(B) The contract between a privately owned or operated ground ambulance services or-
ganization and the local government entity if the ground ambulance services are provided
by a privately owned or operated ground ambulance services organization.
(c) “Ground ambulance services” means:
(A) The rendering of medical treatment and care at the scene of a medical emergency
or while transporting an individual from the scene to an appropriate health care facility
when the services are provided by one or more ground ambulance vehicles designed for this
purpose; and
(B) Transport between health care facilities when the services are medically necessary
and are provided by one or more ground ambulance vehicles designed for this purpose.
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 711 A-Eng. HB 3243
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(d) “Ground ambulance services organization” means a public or private organization li-
censed by the Oregon Health Authority pursuant to ORS 682.045 to provide ground ambu-
lanceservices.
(e) “Health benefit plan” has the meaning given that term in ORS 743B.005, except that
“health benefit plan” does not include a coverage offered by the Public Employees’ Benefit
Board or the Oregon Educators Benefit Board through a commercial insurer, a health care
service contractor or a third party administrator.
(f) “Health care facility” means a facility that provides health care services directly to
patients, including but not limited to a hospital, clinic, health care provider’s office, health
maintenance organization, diagnostic or treatment center, mental health facility, behavioral
health service provider, emergency services provider or hospice or nursing home.
(g) “In-network” has the meaning given that term in ORS 743B.280.
(2) A ground ambulance service may not bill an enrollee for covered ground ambulance
services if the enrollee has paid the in-network cost-sharing amount specified in the
enrollee’s health benefit plan.
(3) A health benefit plan must reimburse the ground ambulance services organization at
the established local rate or if an established local rate does not exist, in an amount no less
than 325 percent of the Medicare rate.
(4) Ground ambulance services organizations shall submit a catalog of established local
rates to the Department of Consumer and Business Services annually and within five calen-
dar days of a change to the rates.
(5) The department shall create a database of established local rates for ground ambu-
lance services. The department shall ensure this database is accessible by the public.
(6) The provisions of this section apply to a self-funded group health plan whether gov-
erned by or exempt from the provisions of the Employee Retirement Income Security Act
of 1974 (29 U.S.C. 1001 et seq.), as amended, only if the self-funded group health plan elects
to participate in the provisions of this section by providing notice to the department in the
form and manner described by the department by rule.
(7) The Public Employees’ Benefit Board and the Oregon Educators Benefit Board may
elect to participate in the coverage provisions described in this section by providing notice
to the department in the form and manner described by the department by rule.
(8) This section is exempt from ORS 743A.001.
(9) The department shall make rules to implement the provisions described in this sec-
tion.
(10) The department may impose civil penalties, as described in ORS 731.988, but may not
exceed $1,000 for repeated violations of this section.
SECTION 3. No later than September 15, 2026, the Department of Consumer and Business
Services shall submit a report in the form and manner described in ORS 192.245 to the in-
terim committees of the Legislative Assembly related to health. The report shall include:
(1) All consumer complaints received by the department concerning billing for services
provided by ground ambulance services organizations both before and after the implementa-
tion of section 2 of this 2025 Act.
(2) The number of contracts ground ambulance services organizations and health benefit
plans entered into on orafter January 1, 2026.
(3) Any effect on the premium rates for health benefit plans that occurred on or after
[2] A-Eng. HB 3243
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January 1, 2026, and can be attributed to the implementation of section 2 of this 2025 Act.
SECTION 4. Section 3 of this 2025 Act is repealed on January 2, 2027.
SECTION 5.Section 2 of this 2025 Act applies to health benefit plans issued, renewed or
extended on or after the effective date of this 2025 Act.
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