Oregon Medical Bill Rights & Programs: Free Nonprofit Hospital Care, Credit Report Ban, and the Providence Investigation

Oregon Balance Billing Law (Effective 2018, Strengthened by SB 1067):

Oregon passed surprise billing protections in 2018, years before the federal No Surprises Act. The law prevents out-of-network providers at in-network facilities from billing you for more than your in-network cost-sharing amount:

• Emergency services: You pay only in-network cost-sharing, regardless of whether the facility or provider is in-network.
• In-network facility, out-of-network provider: Out-of-network providers at in-network hospitals cannot balance bill you for inpatient or outpatient services.
• Labor and delivery during emergencies: If you are diverted to an out-of-network facility due to a public health emergency, your plan must apply in-network cost-sharing.
• Informed consent required: If you voluntarily choose an out-of-network provider, the provider must inform you in advance that you will be responsible for additional costs.

What Hospitals Cannot Do (ORS 646A.677):

• Cannot send you to collections before screening. Under ORS 646A.677, hospitals must conduct a financial assistance screening before transferring an unpaid charge to a debt collector or referring it for collection.
• Cannot collect from your family members. A hospital or debt collector may not attempt to collect a medical debt from a patient's child or other family member (ORS 646A.677).
• Cannot charge excessive interest. Interest on medical debt is capped between 2% and 5% per year, tied to the one-year Treasury yield (ORS 646A.677). No interest at all is allowed on debt from patients who qualify for 100% free care.
• Cannot report medical debt to credit bureaus. Starting January 1, 2026, SB 605 prohibits all medical debt credit reporting. Violations are actionable under the Unlawful Trade Practices Act.
• Cannot bill OHP patients. Under ORS 414.066, providers cannot bill patients for services covered by medical assistance (OHP/Medicaid), except for authorized copayments. Providers must wait at least 90 days and verify eligibility before sending to collections.

Wage Garnishment and Asset Protections:

If a hospital or debt collector does sue and wins a judgment, Oregon law limits how much they can take:

• Wage garnishment limit: Creditors can garnish the lesser of 25% of disposable earnings or the amount exceeding the exempt minimum. As of July 2025, the exempt minimum is $338/week, rising to $400/week in July 2026.
• Homestead exemption: Oregon protects up to $150,000 of home equity from creditors ($300,000 if jointly owned). A medical debt judgment generally cannot force the sale of your home if your equity is below this threshold.
• Bank account protections: Social Security, SSI, up to $7,500 in exempt wages, retirement benefits, unemployment, and disability benefits held in any bank account are protected from garnishment.

Oregon's Unique CCO-Based Medicaid System:

Oregon's Medicaid program operates through 16 Coordinated Care Organizations (CCOs), which are regional health networks that coordinate physical, mental, dental, and behavioral health care under a single plan. This model is unique among US states and means OHP members get truly integrated care.

• • OHP Plus (traditional Medicaid): Adults up to 138% FPL (~$22,000/year for a single person). No asset test. Covers medical, dental, vision, behavioral health, and substance use treatment.
• • OHP Bridge (launched July 2024): Adults 19-64 with income between 138% and 200% FPL (~$22,000 to ~$31,920/year for a single person) who lack access to affordable insurance. No premiums, copays, or deductibles. Projected to cover about 100,000 Oregonians.
• • Children: Up to 305% FPL through CHIP.
• • Pregnant individuals: Up to 185% FPL (some income disregards may allow higher).

Oregon Resources for Medical Bill Help: