Rules Proposed: OAR 836-053-0444, 836-053-0447, 836-053-0451, 836-053-0454, 836-053-0457, 836-053-0461
RULE SUMMARY: HB 3243 (2025) is intended to protect Oregon consumers from out-of-network balance billing for ground ambulance services. The law prohibits billing health benefit plan enrollees more than the in-network cost sharing amount for these services and sets minimum thresholds for health benefit plan reimbursement. The law requires the Department of Consumer and Business Services (DCBS) to make rules to implement the provisions described in Section 2 of the bill. The proposed rules provide implementation requirements regarding:
- Consumer cost-sharing for ground ambulance services, including a required timeline for reimbursing consumers for erroneous overpayments.
- Minimum payment amounts to ground ambulance services organizations (GASOs) that are set according to Medicare rates.
- GASO established local rate reporting requirements to the department.
- Requirements for self-funded employer group health plans and State of Oregon PEBB and OEBB plans that elect to participate to opt-in to Oregon's ground ambulance balance billing law.
FILED: 3/26/2026
HEARING DATE/TIME: 04/22/2026, 1:30 PM - 2:30 PM
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