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HB2540 • 2025

Requires certain health insurers to credit any amount an enrollee pays directly to a provider toward out-of-pocket costs and deductibles in certain circumstances.

Requires certain health insurers to credit any amount an enrollee pays directly to a provider toward out-of-pocket costs and deductibles in certain circumstances.

Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Representative Diehl,, Javadi,, McIntire,, Pham H, Representative Andersen,, Boshart Davis,, Evans,, Fahey,, Harbick,, Hudson,, Levy B,, Nelson,, Neron,, Nosse,, Skarlatos,, Watanabe,, Yunker,, Senator Bonham,, Hayden,, McLane,, Patterson,, Smith DB,
Last action
2025-06-11
Official status
Chapter Number Assigned
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Requires certain health insurers to credit any amount an enrollee pays directly to a provider toward out-of-pocket costs and deductibles in certain circumstances.

Digest: Makes certain health insurers credit certain costs to an enrollee's health plan.

What This Bill Does

  • Digest: Makes certain health insurers credit certain costs to an enrollee's health plan.
  • (Flesch Readability Score: 60.7).
  • Requires certain health insurers to credit any amount an enrollee pays directly to a provider toward out-of-pocket costs and deductibles in certain circumstances.
  • Relating to: Relating to medical out-of-pocket costs.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2025-06-11 House

    Chapter 120, (2025 Laws): Effective date January 1, 2026.

  2. 2025-05-22 House

    Governor signed.

  3. 2025-05-15 Senate

    President signed.

  4. 2025-05-14 House

    Speaker signed.

  5. 2025-05-13 Senate

    Third reading. Carried by Hayden. Passed. Ayes, 29; Excused, 1--Gelser Blouin.

  6. 2025-05-12 Senate

    Carried over to 05-13 by unanimous consent.

  7. 2025-05-08 Senate

    Carried over to 05-12 by unanimous consent.

  8. 2025-05-07 Senate

    Recommendation: Do pass the A-Eng. bill.

  9. 2025-05-07 Senate

    Second reading.

  10. 2025-04-29 Senate

    Work Session held.

  11. 2025-04-17 Senate

    Public Hearing held.

  12. 2025-03-18 Senate

    First reading. Referred to President's desk.

  13. 2025-03-18 Senate

    Referred to Health Care.

  14. 2025-03-17 House

    Third reading. Carried by Diehl. Passed. Ayes, 53; Excused, 7--Evans, Levy E, Nguyen H, Owens, Smith G, Valderrama, Wright.

  15. 2025-03-13 House

    Second reading.

  16. 2025-03-12 House

    Recommendation: Do pass with amendments and be printed A-Engrossed.

  17. 2025-03-06 House

    Work Session held.

  18. 2025-02-25 House

    Public Hearing held.

  19. 2025-02-13 House

    Public Hearing cancelled.

  20. 2025-01-17 House

    Referred to Behavioral Health and Health Care.

  21. 2025-01-13 House

    First reading. Referred to Speaker's desk.

Official Summary Text

Digest: Makes certain health insurers credit certain costs to an enrollee's health plan. (Flesch Readability Score: 60.7).
Requires certain health insurers to credit any amount an enrollee pays directly to a provider toward out-of-pocket costs and deductibles in certain circumstances.
Relating to: Relating to medical out-of-pocket costs.
Current location: Chapter Number Assigned

Current Bill Text

Read the full stored bill text 
83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
Enrolled
House Bill 2540
Sponsored by Representatives DIEHL, JAVADI, MCINTIRE, PHAM H; Representatives
ANDERSEN, BOSHART DAVIS, EVANS, FAHEY, HARBICK, HUDSON, LEVY B, NELSON,
NERON, NOSSE, SKARLATOS, WATANABE, YUNKER, Senators BONHAM, HAYDEN,
MCLANE, PATTERSON, SMITH DB (Presession filed.)
CHAPTER .................................................
AN ACT
Relating to medical out-of-pocket costs.
Be It Enacted by the People of the State of Oregon:
SECTION 1.
Section 2 of this 2025 Act is added to and made a part of ORS 743B.280 to
743B.285.
SECTION 2. (1) An insurer offering a health benefit plan as defined in ORS 743B.005 shall
credit any amount an enrollee pays directly to a health care provider to the enrollee’s
deductible and annual out-of-pocket expenses if:
(a) The health care item or service is medically necessary and covered under the
enrollee’s health benefit plan;
(b) The enrollee does not submit the claim to the insurer; and
(c) The amount paid to the health care provider is less than the average discounted rate
for the item or service paid to an in-network health care provider with the same license.
(2) An insurer shall:
(a) Establish a process for an enrollee to submit a claim for the credit described in sub-
section (1) of this section, including the necessary documentation the enrollee is required to
submit in support of the claim; or
(b) Require an enrollee to utilize the system the insurer uses to process and adjudicate
claims to submit a claim for the credit described in subsection (1) of this section.
(3) Notwithstanding ORS 750.055 (1)(i), this section does not apply to a health mainte-
nance organization as defined in ORS 750.005.
SECTION 3.
Section 2 of this 2025 Act applies to a health benefit plan issued, renewed
or extended on or after the effective date of this 2025 Act.
Enrolled House Bill 2540 (HB 2540-A) Page 1
Passed by House March 17, 2025
..................................................................................
Timothy G. Sekerak, Chief Clerk of House
..................................................................................
Julie Fahey, Speaker of House
Passed by Senate May 13, 2025
..................................................................................
Rob Wagner, President of Senate
Received by Governor:
........................M.,........................................................., 2025
Approved:
........................M.,........................................................., 2025
..................................................................................
Tina Kotek, Governor
Filed in Office of Secretary of State:
........................M.,........................................................., 2025
..................................................................................
Tobias Read, Secretary of State
Enrolled House Bill 2540 (HB 2540-A) Page 2