ORS 441.098: Health practitioner referral of patient to treatment or diagnostic testing facility; definitions for ORS 441.098, 441.099 and 441.991; rules.

(1) As used in this section and ORS 441.099 and 441.991: (a) “Facility” means a hospital, outpatient clinic owned by a hospital, ambulatory surgical center, freestanding birthing center or facility that receives Medicare reimbursement as an independent diagnostic testing facility. (b) “Financial interest” means a five percent or greater direct or indirect ownership interest. (c)(A) “Health practitioner” means a physician, naturopathic physician licensed under ORS chapter 685, dentist, direct entry midwife, licensed physician associate or medical imaging licensee under ORS 688.405 to 688.605 or a nurse practitioner or nurse practitioner specializing in nurse midwifery licensed under ORS chapter 678. (B) “Health practitioner” does not include a provider in a health maintenance organization as defined in ORS 750.005. (d) “Physician” has the meaning given that term in ORS 677.010. (2) A health practitioner’s decision to refer a patient to a facility for a diagnostic test or health care treatment or service shall be based on the patient’s clinical needs and personal health choices. (3) If a health practitioner refers a patient for a diagnostic test or health care treatment or service at a facility in which the health practitioner or an immediate family member of the health practitioner has a financial interest, the health practitioner or the practitioner’s designee shall inform the patient orally and in writing of that interest at the time of the referral. (4)(a) If a health practitioner refers a patient to a facility for a diagnostic test or health care treatment or service, the health practitioner or the practitioner’s designee shall inform the patient, in the form and manner prescribed by the Oregon Health Authority by rule, that: (A) The patient may receive the test, treatment or service at a different facility of the patient’s choice; and (B) If the patient chooses a different facility, the patient should contact the patient’s insurer regarding the extent of coverage or the limitations on coverage for the test, treatment or service at the facility chosen by the patient. (b) Rules concerning the form and manner for informing a patient as required by this subsection shall: (A) Be designed to ensure that the information is conveyed in a timely and meaningful manner; (B) Be administratively simple; and (C) Accommodate a provider’s adoption and use of electronic health record systems. (5) A health practitioner may not deny, limit or withdraw a referral to a facility solely for the reason that the patient chooses to obtain the test, treatment or service from a different facility. (6) The authority may not impose additional restrictions or limitations on any referral described in this section that are in addition to the requirements specified in subsections (3) and (4) of this section. (7) In obtaining informed consent for a diagnostic test or health care treatment or service that will take place at a facility, a health practitioner shall disclose the manner in which care will be provided in the event that complications occur that require health services beyond what the facility has the capability to provide. (8) Subsections (3) to (5) of this section do not apply to a referral for a diagnostic test or health care treatment or service: (a) For a patient who is receiving inpatient hospital services or services in an emergency department if the referral is for a diagnostic test or health care treatment or service to be performed while the patient is in the hospital or emergency department; (b) Made to a particular facility after the initial referral of the patient to that facility; or (c) Made by the facility or provider to whom a patient was referred. [2009 c.792 §3; 2013 c.129 §30; 2013 c.552 §1; 2017 c.356 §69; 2019 c.233 §2; 2019 c.358 §15a; 2024 c.73 §91]