October 29, 2019
On July 15, 2019, Gov. Brown signed SB 526 into law. Effective September 29, 2019, the law requires health benefit policies issued in Oregon to reimburse the cost of newborn nurse visiting services. The coverage must be provided without any cost-sharing, coinsurance, or deductibles to families with newborns up to six months old.
Although insurers must offer these nurse services in health benefit plans, an eligible enrollee is not required to receive the services as a condition of coverage. Additionally, the carrier is responsible for notifying an enrollee about the services whenever an enrollee adds a newborn to coverage. Carriers may use in-network providers or may contract with local public health authorities to provide such services.
The measures are primarily directed towards insurers. However, Oregon employers should be aware of the new coverage requirements, particularly if planning to offer an HDHP option with an HSA program. An HDHP cannot provide for cost sharing, with the exception of preventive care, before the deductible is satisfied. Accordingly, it may be advisable for employers to talk to counsel about the impact of the new state mandate on HDHP/HSA arrangements
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