Oregon Revised Statutes Chapter 442 § 442.612 — Definitions

Definitions. As used in ORS 442.612 to 442.630: (1) “Adjust” means to reduce a patient’s cost by a specified percentage. (2) “Community benefit” has the meaning given that term in ORS 442.601. (3) “Gross charges” means a hospital’s full, established price for medical care that the hospital consistently and uniformly charges patients before applying any contractual allowance, discounts or deductions. (4)(a) “Hospital” has the meaning given that term in ORS 442.015, excluding any campus of the Oregon State Hospital, a hospital operated by the United States Department of Veterans Affairs Veterans Health Administration or any other hospital operated by the federal government. (b) “Hospital” includes only hospitals located in this state. (5) “Hospital-affiliated clinic” or “affiliated clinic” means a facility located in this state that provides outpatient health services and that is operated under the common control or ownership of a hospital. (6) “Household” means: (a)(A) A single individual; or (B) Spouses, domestic partners, or a parent and child under 18 years of age, living together; and (b) Other individuals for whom a single individual, spouse, domestic partner or parent is financially responsible. (7) “Medically necessary” means: (a) Necessary to prevent, diagnose or treat an illness, injury, condition or disease, or the symptoms of an illness, injury, condition or disease; and (b) Meeting accepted standards of medicine. (8) “Nonprofit” means: (a) Organized not for profit, pursuant to ORS chapter 65 or any predecessor of ORS chapter 65; or (b) Organized and operated as described under section 501(c) of the Internal Revenue Code as defined in ORS 305.842. (9) “Patient’s cost” means the portion of charges billed to a patient for care received at a hospital or a hospital-affiliated clinic that are not reimbursed by insurance or a publicly funded health care program, taking into account the requirements of section 501(r)(5) of the Internal Revenue Code that: (a) Prohibit a nonprofit hospital from billing gross charges; and (b) Limit amounts charged for emergency or other medically necessary care, to a patient who qualifies under the nonprofit hospital’s financial assistance policy, to no more than amounts generally billed to a patient who has insurance that reimburses all or a portion of the cost of the care. (10) “Social determinants of health” means the social, economic and environmental conditions in which people are born, grow, work, live and age, shaped by the distribution of money, power and resources at local, national and global levels, institutional bias, discrimination, racism and other factors. [2019 c.497 §1; 2021 c.96 §3] Note: See note under 442.610.