New Oregon Rules Set Standardized Payment and Rate Reporting for Ground Ambulance Services Under HB 3243

OR| Oregon‘s Permanent Administraive Order ID 7-2026 implements HB 3243 (2025), which prohibit balance billing of health benefit plan enrollees for covered ground ambulance services once the enrollee has paid the in‑network cost‑sharing amount, establish how health plans must determine and pay allowed amounts to ground ambulance service organizations (using established local rates, contracted rates, or at least 325% of Medicare), require direct payment to ambulance providers, mandate annual and updated electronic reporting of established local and contracted ambulance rates to the Department of Consumer and Business Services, and create an opt‑in process under ORS 743B.292 for self‑funded group health plans, the Public Employees’ Benefit Board, and the Oregon Educators Benefit Board — including certain out‑of‑state employers — to extend these ground ambulance balance billing protections to their enrollees, effective for health benefit plans issued, renewed, or extended on or after January 1, 2026, with the rules themselves effective June 29, 2026.

Click here to see OR Administrative Order ID 7-2026