OR SB822

Expands network adequacy requirements for individual and group health benefit plans to include mental health, substance use disorder, and reproductive health care services accessible in a culturally competent manner to enrollees with diverse backgrounds, disabilities, or health conditions

Requires the Department of Consumer and Business Services to conduct annual evaluations of carrier provider networks using nationally recognized standards consistent with federal regulations (45 C.F.R. 156.230), including geographic access standards and wait time limits for appointments

Mandates carriers maintain adequate networks of mental and behavioral health providers (licensed counselors, marriage and family therapists, clinical social workers, psychologists, and psychiatrists) who are accepting new patients across all geographic areas where plans are offered

Establishes standards for telemedicine services that carriers may use to demonstrate network adequacy compliance, while prohibiting carriers from using telemedicine providers alone to meet network standards except as permitted by department rules

Updates anti-discrimination provisions for provider participation to align with federal standards in effect as of January 1, 2025 (42 U.S.C. 300gg-5)