Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-1305 - Definitions; Authority to Act for Enrollee
Universal Citation: OR Admin Rules 836-053-1305
Current through Register Vol. 63, No. 9, September 1, 2024
(1) As used in OAR 836-053-1300 to 836-053-1365, "medical reviewer" means any of the following persons who is assigned to an independent review case by an independent review organization:
(a) A doctor of medicine or osteopathy
licensed under ORS Chapter 677 or under the laws of another state.
(b) A provider as defined in ORS
743B.001(16)(a)(b).
(c) A health care professional licensed,
certified or otherwise authorized or permitted by the laws of another state to
administer medical or mental health services in the ordinary course of business
or practice of a profession.
(2) An action that may be taken by an enrollee under ORS 743B.252 to 743B.256 or under OAR 836-053-1300 to 836-053-1365 may be taken on behalf of the enrollee by a representative of the enrollee.
Statutory/Other Authority: ORS 731.244 & ORS 743B.253 - 743B.256
Statutes/Other Implemented: ORS 743B.252 - 743B.256 & ORS 743B.001
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