Oregon Issues Temporary Administrative Order on Ground Ambulance Reimbursement Requirements

January 13, 2026

On December 17, 2025, the Oregon Department of Consumer and Business Services (DCBS) issued Temporary Administrative Order ID 15-2025 on ground ambulance reimbursement requirements for health benefit plans issued, renewed, or extended on or after January 1, 2026. Ground ambulance services include medical treatment and care provided at the scene of an emergency/during transport to a healthcare facility, or between healthcare facilities when medically necessary. The Temporary Administrative Order implements provisions of Oregon House Bill 3243 by:

• Reiterating that a health plan enrollee may not be balance billed for ground ambulance services if the enrollee has paid the in-network cost-sharing amount under the enrollee’s health plan.
• Establishing methods to determine the allowed amount when paying ground ambulance service organizations within and outside their service areas and whether the ambulance is publicly or privately owned.
• Mandating the health benefit plan provide an explanation of benefits to the enrollee and the ground ambulance services organization that reflects the cost-sharing amount determined.
• Requiring health benefit plans to make payments directly to ground ambulance service organizations rather than the enrollee.
• Barring ground ambulance service organizations from requesting or requiring a patient to waive or modify provisions of this Temporary Administrative Order.
• Indicating that self-funded plans, as well as the Public Employees' Benefit Board and the Oregon Educators Benefit Board, may opt-in to this ground ambulance mandate by providing notice to DCBS on a form DCBS develops.

The Temporary Administrative Order is effective January 1, 2026, through June 29,2026. Permanent rulemaking is expected later.

For more information, please see the official text of the Temporary Administrative Order. For more background, review HB 3243 (2025) Ground Ambulance Balance Billing Law on the Oregon Legislative website.