Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-0330 - Nationally Recognized Standards for Use in Demonstrating Compliance with Network Adequacy Requirements
Current through Register Vol. 63, No. 9, September 1, 2024
(1) Beginning with plan year 2020, an insurer electing to demonstrate compliance with network adequacy requirements established in ORS 743B.505 by submitting for each network evidence of compliance with a nationally recognized standard may use the federal network adequacy standards applicable to Medicare Advantage plans, adjusted to reflect the age demographics of the enrollees in the plan. An insurer must adjust the Medicare Advantage network adequacy standards to ensure these specialties are included for the age demographics of the population covered by the network plan:
(2) The evidence of compliance with a nationally recognized standard must be submitted to the Director no later than March 31 each year for the immediately preceding calendar year as of December 31.
Statutory/Other Authority: ORS 731.244 & ORS 743B.505
Statutes/Other Implemented: ORS 743B.505