As used in OAR 836-053-0444 to 836-053-0461:

1. (1) “Enrollee” has the meaning given that term in ORS 743B.005.

2. (2) “Established local rate” means the rate established where the health care services originated for the provision of ground ambulance services through a publicly accessible process that includes an analysis of the cost to provide the ground ambulance services by:

   1. (a) The local government entity if the ground ambulance services are provided by ground ambulance services organizations that are owned or operated by the local government entity; or
   2. (b) The contract between a privately owned or operated ground ambulance services organization and the local government entity if the ground ambulance services are provided by a privately owned or operated ground ambulance services organization.

3. (3) “Ground ambulance services” means:

   1. (a) The rendering of medical treatment and care at the scene of a medical emergency or while transporting an individual from the scene to an appropriate health care facility when the services are provided by one or more ground ambulance vehicles designed for this purpose; and
   2. (b) Transport between health care facilities when the services are medically necessary and are provided by one or more ground ambulance vehicles designed for this purpose.
4. (4) “Ground ambulance services organization” means a public or private organization licensed by the Oregon Health Authority pursuant to ORS 682.045 to provide ground ambulance services.
5. (5) “Health benefit plan” has the meaning given that term in ORS 743B.005, except that “health benefit plan” does not include a coverage offered by the Public Employees’ Benefit Board or the Oregon Educators Benefit Board through a commercial insurer, a health care service contractor or a third party administrator.
6. (6) “Health care facility” means a facility that provides health care services directly to patients, including but not limited to a hospital, clinic, health care provider’s office, health maintenance organization, diagnostic or treatment center, mental health facility, behavioral health service provider, emergency services provider or hospice or nursing home.
7. (7) “In-network” has the meaning given that term in ORS 743B.280.
8. (8) “Mutual aid transport” means a transport by a ground ambulance service organization that originates outside their designated area and is requested or subject to an agreement between ground ambulance service providers for reciprocal services.
9. (9) “Nonresident” means a patient that does not reside in a ground ambulance service organization’s service area.
10. (10) “Resident” means a patient that resides in ground ambulance service organization’s service area.

Statutory/Other Authority

ORS 743B.292

Statutes/Other Implemented

ORS 743B.292

History

ID 7-2026, adopt filed 06/24/2026, effective 06/29/2026
ID 15-2025, temporary adopt filed 12/17/2025, effective 01/01/2026 through 06/29/2026