(1) "Claim for health care payment" means any request or demand for a health care payment, whether made in the form of a bill, claim form, cost report, invoice, electronic transmission or any other document. "Claim for health care payment" does not include any statement by a person on an application for coverage under a contract or certificate of health care coverage issued by an insurer, health care service contractor, health maintenance organization or other legal entity that is self-insured and provides health care benefits to its employees.
(2) "Health care payment" means money paid in compensation for the delivery of specified health care services, whether under a contract, certificate or policy of insurance, by a health care payor.
(3) "Health care payor" means:
(a) Any insurance company authorized to provide health insurance in this state;
(b) A health maintenance organization;
(c) A health care service contractor;
(d) Any legal entity that is self-insured and provides benefits for health care services to its employees;
(e) Any legal entity responsible for handling claims for health care services under a state or federal medical assistance program;
(f) The State of Oregon or any local government within this state that makes payments for health care services;
(g) Any insurer authorized under ORS chapter 731 to transact workers’ compensation or casualty insurance in this state; or
(h) Any employer authorized under ORS chapter 656 to self-insure its workers’ compensation risk.
(4) "Health care services" means any medical or remedial care or service, including supplies delivered in connection with the care or service, that is recognized under state law.
(5) "Person" means an individual, corporation, partnership or association that provides health care services or any other form of legal or business entity that provides health care services. [1995 c.496 §1; 2001 c.556 §1]
Structure 2021 Oregon Revised Statutes
Volume : 04 - Criminal Procedure, Crimes
Chapter 165 - Offenses Involving Fraud or Deception
Section 165.002 - Definitions for ORS 165.002 to 165.070.
Section 165.007 - Forgery in the second degree.
Section 165.013 - Forgery in the first degree.
Section 165.017 - Criminal possession of a forged instrument in the second degree.
Section 165.022 - Criminal possession of a forged instrument in the first degree.
Section 165.027 - Evidence admissible to prove forgery or possession of forged instrument.
Section 165.032 - Criminal possession of a forgery device.
Section 165.037 - Criminal simulation.
Section 165.042 - Fraudulently obtaining a signature.
Section 165.047 - Unlawfully using slugs.
Section 165.055 - Fraudulent use of a credit card.
Section 165.065 - Negotiating a bad check.
Section 165.070 - Possessing fraudulent communications device.
Section 165.072 - Definitions for ORS 165.072 and 165.074.
Section 165.074 - Unlawful factoring of payment card transaction.
Section 165.075 - Definitions.
Section 165.080 - Falsifying business records.
Section 165.085 - Sports bribery.
Section 165.090 - Sports bribe receiving.
Section 165.095 - Misapplication of entrusted property.
Section 165.100 - Issuing a false financial statement.
Section 165.102 - Obtaining execution of documents by deception.
Section 165.109 - Failing to maintain a cedar purchase record.
Section 165.114 - Sale of educational assignments.
Section 165.116 - Definitions for ORS 165.116 to 165.124.
Section 165.118 - Metal property offenses.
Section 165.124 - Application of ORS 164.857, 165.116, 165.117, 165.118 and 165.122.
Section 165.127 - County metal theft plan of action.
Section 165.535 - Definitions applicable to obtaining contents of communications.
Section 165.540 - Obtaining contents of communications.
Section 165.542 - Reports required concerning use of electronic listening device.
Section 165.543 - Interception of communications.
Section 165.555 - Unlawful telephone solicitation of contributions for charitable purposes.
Section 165.570 - Improper use of emergency communications system.
Section 165.572 - Interference with making a report.
Section 165.575 - Definitions for ORS 165.575 to 165.583.
Section 165.577 - Cellular counterfeiting in the third degree.
Section 165.579 - Cellular counterfeiting in the second degree.
Section 165.581 - Cellular counterfeiting in the first degree.
Section 165.583 - Exemptions from ORS 165.577, 165.579 and 165.581.
Section 165.657 - Definitions for ORS 165.659 to 165.669.
Section 165.661 - When provider of communication service may use devices.
Section 165.663 - Use by police; application to court; statement required.
Section 165.667 - Order by court; findings; contents of order.
Section 165.690 - Definitions for ORS 165.690, 165.692 and 165.694.
Section 165.692 - Making false claim for health care payment.
Section 165.694 - Aggregation of claims.
Section 165.800 - Identity theft.
Section 165.803 - Aggravated identity theft.
Section 165.805 - Misrepresentation of age by a minor.
Section 165.810 - Unlawful possession of a personal identification device.
Section 165.813 - Unlawful possession of fictitious identification.
Section 165.815 - Criminal impersonation.
Section 165.825 - Sale of drugged horse.
Section 165.845 - Making and drawing of checks and notes by wire.