OR HB3591

Insurers offering group or individual health benefit plans must reimburse out-of-network providers for pediatric care at the same rate as in-network providers for the same service, treatment, or procedure

Out-of-pocket costs such as copayments, deductibles, and coinsurance for out-of-network pediatric care cannot exceed those charged for in-network pediatric care

Out-of-network providers licensed in Oregon are prohibited from charging insured patients more than the reimbursement amount paid by the health plan for covered pediatric care services

Pediatric care is defined as health care treating physical, behavioral, and developmental issues affecting children from birth to 18 years of age

Requirements apply to Public Employees' Benefit Board (PEBB), Oregon Educators Benefit Board (OEBB), health care service contractors, and multiple employer welfare arrangements, effective January 1, 2026