Oregon Health Insurance Exchange, Chapter 945
Rule Caption: Qualified Health Plan Addendum for Indian Health Providers
Adm. Order No.: OHIE 4-2013
Filed with Sec. of State: 7-9-2013
Certified to be Effective: 7-9-13
Notice Publication Date: 6-1-2013
Rules Adopted: 945-020-0040
Subject: Adopts the Qualified Health Plan Addendum for Indian Health Care Providers, and requires insurers to use the addendum when contracting with Indian health providers for services to be offered as part of a plan certified by the Exchange as a qualified health plan.
Rules Coordinator: Gregory Jolivette—(503) 373-9406
Qualified Health Plan Addendum for Indian Health Care Providers
(1) The Exchange adopts by reference the Qualified Health Plan (QHP) Addendum for Indian Health Care Providers.
(2) If a health insurer contracts with a Tribal Health Provider in the state of Oregon for services to be offered through a health benefit plan certified by the Exchange as a QHP, the issuer must:
(a) Use the QHP Addendum for Indian Health Care Providers to supplement and amend their existing provider contract, and
(b) Notify the Exchange of the contractual relationship by contacting an Exchange carrier account executive.
(3) The Exchange reserves the right to amend the QHP Addendum for Indian Health Care Providers using the rulemaking process. Contracted carriers and tribes will be required to amend their contracts to reflect any change to the QHP Addendum for Indian Health Care Providers within 90 days of adoption of the change.
Stat. Auth.: ORS 741.002
Stats. Implemented: ORS 741.310
Hist.: OHIE 4-2013, f. & cert. ef. 7-9-13
Oregon State Archives • 800 Summer St. NE • Salem, OR 97310