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Out-of-network reimbursement rulemaking (SB 1549)

The Department of Consumer and Business Services (DCBS) adopted final rules implementing SB 1549 (2018). The rules set the method of reimbursement for an out-of-network provider of emergency services or other covered inpatient or outpatient services provided at an in-network health care facility. The rule was adopted December 18, 2018, and became effective January 1, 2019.

Final Rule

CPI Adjustment

Under SB 1549, reimbursement rates for out-of-network services must be adjusted annually using the U.S. City Average Consumer Price Index for All Urban Consumers (All Items) (CPI-U) as published by the Bureau of Labor Statistics of the United States Department of Labor. The final rule provides that the adjustment for services performed in a particular year shall be based on percent change from January 2015 to July of the prior year.

Year Services Performed

Percent Change

2019

107.83%

2020

109.78%

Meetings and documents

Public comments received

Committee members

Committee contact

Alex Cheng
Senior Policy Analyst,
Oregon Division of Financial Regulation
Phone: (503) 947-7242
Email: alexander.s.cheng@oregon.gov

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