ORS Chapter 445
Chapter 445 — IndigentPersons Injured in Motor Vehicle Accidents
2009 EDITION
INDIGENTPERSONS INJURED IN VEHICLE ACCIDENTS
PUBLICHEALTH AND SAFETY
445.010 Definitions
445.020 Determinationof indigency
445.030 MotorVehicle Accident Fund; source; uses
445.050 Jurisdiction;rules
445.060 Limitationon benefits for care supplied
445.070 Additionalbenefits permitted within limits
445.090 Filingof claims; time for filing
445.110 Hospitalclaims; form and contents
445.120 Filingof claims generally; combining claims
445.130 Effectof liability of third person or commencement of legal action on settlement ofclaim
445.140 Auditand determination of validity of claims
445.150 Orderallowing or rejecting claim; notice
445.155 Judicialreview
445.180 Reassignmentof rights to claimant on notice of finding person liable for care
445.185 Whendeduction may be made from payments on claim
445.010Definitions.As used in this chapter, unless the context requires otherwise:
(1)“Ambulance operator” means any person operating an ambulance for hire.
(2)“Authority” means the Oregon Health Authority.
(3)“Care” means:
(a)Treatment in and by a hospital.
(b)Professional services of a doctor.
(c)Professional services of a nurse.
(d)Medicines, substances, articles, appliances or physical therapy supplied on theprescription or order of the doctor in charge of the case.
(e)Transportation and services by an ambulance operator.
(f)Supplying prosthetic appliances and services.
(g)Any combination of any two or more of the services listed in this subsection.
(h)Professional services of a licensed physical therapist.
(4)“Claimant” means a hospital, doctor, nurse, pharmacy, ambulance operator,supplier of prosthetic appliances and services or licensed physical therapist,who supplies care to an indigent patient, and who files a claim for chargestherefor pursuant to this chapter. In respect of a hospital, it includes theoperator or managing officer thereof. “Claimant” also means an indigent patient,or a personal representative of the patient after the death of the patient, butclaims allowed shall be paid directly to those who supply care to the indigentpatient; and an indigent claimant, or personal representative of the patient,has no right of appeal under ORS 445.160 (1969 Replacement Part).
(5)“Doctor” means a person licensed by the appropriate board of this state topractice one or more of the healing arts.
(6)“Hospital” includes nursing homes and means any institution that has a provideragreement with the authority and which admits and cares for patients sufferingfrom motor vehicle injuries and applies for the benefits of this chapter in themanner provided in ORS 445.110.
(7)“Indigent patient” means a person who has suffered a motor vehicle injury andwho is unable to pay the cost of the care supplied on account of such injuryand, except in the case of a claim filed after a claim arising out of the samemotor vehicle injury has been allowed by the authority or finally adjudged affirmativelyby a court on appeal, whose account therefor remains unpaid at the expirationof 90 days after the termination of the care and who is not entitled to thebenefits of the Workers’ Compensation Law of this state or any other state orcountry on account of such injury.
(8)“Motor vehicle injury” means any personal injury suffered by a human being, andaccidentally caused in, by, or as the proximate result of, the movement of amotor vehicle on a public way, street or highway within this state, whether theinjured person is the operator of the vehicle, a passenger in the same oranother vehicle, a pedestrian or whatever the relationship of the injuredperson to the movement of the vehicle, and whether or not the vehicle is underthe control of a human being at the time of the injury.
(9)“Nurse” means a person registered or licensed to practice nursing by the OregonState Board of Nursing.
(10)“Pharmacy” means a place of business licensed by the State Board of Pharmacy,where drugs, medicines, prescriptions, chemicals or poisons are compounded,dispensed or sold at retail.
(11)“Supplier of prosthetic appliances and services” means a place of business orperson licensed to manufacture or supply prosthetic appliances and services.
(12)“Licensed physical therapist” means a physical therapist within the State ofOregon licensed by the Physical Therapist Licensing Board. [Amended by 1953c.399 §1; 1965 c.376 §1; 1969 c.247 §4; 1969 c.260 §1; 1973 c.141 §1; 1983c.740 §164; 1985 c.279 §3; 2001 c.104 §183; 2009 c.595 §801]
445.020Determination of indigency. (1) A person injured by the movement of a motorvehicle is deemed unable to pay the charges for care if it appears that, upondue and diligent search and inquiry, the person, or any other person chargeableby law with the care or support of the person, cannot be found for service ofsummons, or that, should an action be brought and judgment secured against theperson, or against any other person chargeable by law with the care or supportof the person, for the amount of the charges, execution thereon would beunavailing.
(2)Indigency of a patient shall be determined as of the date on which the patientbecomes unable to pay the cost of the care.
445.030Motor Vehicle Accident Fund; source; uses. (1) There is created a fund tobe known as the Motor Vehicle Accident Fund, to be held and deposited by theState Treasurer in such banks as are authorized to receive deposits of theGeneral Fund.
(2)All moneys received by the Oregon Health Authority under this chapter shallforthwith be paid to the State Treasurer, and shall become a part of the fund.
(3)The following shall be paid from the fund:
(a)All claims and benefits allowed by the authority or finally adjudgedaffirmatively by a court on appeal in the amounts allowed or adjudged andwithin the limitations of ORS 445.060 and 445.070.
(b)All expenses of litigation incurred by the authority on any appeal.
(c)All court costs and disbursements assessed against the authority.
(d)All salaries, clerk hire, advances and reimbursement of travel costs andexpenses incurred by the authority in the administration of this chapter.
(e)Expenses incurred by the authority in the administration of the EmergencyMedical Services and Trauma Systems Program created pursuant to ORS 431.623.The total amount of all payments from the fund for purposes of this paragraphshall be equal to $891,450 each biennium.
(4)Liability for payment of claims or judgments thereon, or both, and expensesauthorized by this chapter shall be limited to the fund and all additionsthereto made under this chapter. [Amended by 1965 c.376 §2; 1983 c.338 §29;1983 c.740 §165; 1985 c.279 §4; 1997 c.546 §1; 2001 c.668 §6; 2009 c.595 §802]
445.040 [Repealed by1961 c.672 §2]
445.050Jurisdiction; rules.The Oregon Health Authority may:
(1)Hear and determine all questions within its jurisdiction.
(2)Promulgate and enforce all rules and regulations as may be proper in theadministration and enforcement of this chapter. [Amended by 1985 c.279 §5; 2009c.595 §803]
445.060Limitation on benefits for care supplied. Except as provided in ORS445.070, the payment of benefits authorized by this chapter is limited to caresupplied within one year from the date of the motor vehicle injury and isfurther limited so that for care supplied to any one indigent patient by reasonof any one motor vehicle injury:
(1)No hospital or hospitals shall receive from the fund more than $6,000, in theaggregate, except that a Level I or II trauma hospital or hospitals may receiveup to $12,000, in the aggregate.
(2)No doctor or doctors shall receive from the fund more than $2,500, in theaggregate.
(3)No nurse or nurses shall receive from the fund more than $500, in theaggregate.
(4)No pharmacy or pharmacies shall receive from the fund more than $500, in theaggregate.
(5)No ambulance operator or ambulance operators shall receive from the fund morethan $500, in the aggregate, except that an air ambulance or air ambulances mayreceive up to $2,000, in the aggregate.
(6)No supplier or suppliers of prosthetic appliances and services shall receivefrom the fund more than $500, in the aggregate.
(7)No licensed physical therapist or licensed physical therapists shall receivefrom the fund more than $500, in the aggregate. [Amended by 1953 c.399 §2; 1969c.260 §2; 1973 c.141 §2; 1997 c.546 §2]
445.070Additional benefits permitted within limits. If it is made to appear to theOregon Health Authority that the limitations of ORS 445.060 are not sufficient toprovide necessary and adequate care of an indigent patient and that thecondition of the indigent patient warrants such action, the authority, in itssole discretion, the exercise of which shall be conclusive and not in any wisesubject to review, may authorize the supplying of additional care to theindigent patient of the same type as the types of initial care authorized bythis chapter and may pay for the same from the Motor Vehicle Accident Fund. Noclaim for additional care shall be enforceable under this chapter unless theauthority first approves and authorizes in writing the supplying of suchadditional care. No single authorization shall be for more than:
(1)For additional care supplied by a hospital or hospitals, $500.
(2)For additional care supplied by a doctor or doctors, $300.
(3)For additional care supplied by a nurse or nurses, $200.
(4)For additional care supplied by a pharmacy or pharmacies, $100.
(5)For additional care supplied by an ambulance operator or ambulance operators,$50.
(6)For additional care supplied by a supplier or suppliers of prostheticappliances and services, $100.
(7)For additional care supplied by a licensed physical therapist or licensedphysical therapists, $100. [Amended by 1969 c.260 §3; 1973 c.141 §3; 1985 c.279§6; 2009 c.595 §804]
445.080 [Amended by1983 c.45 §1; repealed by 1985 c.279 §14]
445.090Filing of claims; time for filing. (1) At the time of filing a claim underthis chapter, the claimant shall submit to the Oregon Health Authority suchinformation and data as the authority may reasonably require.
(2)A claim filed under this chapter must be filed with the authority within oneyear after the termination of the care supplied by the claimant. However, incomputing the time there shall not be included that period beginning when anyclaim under ORS chapter 656 arising out of the same motor vehicle accident isfiled by the indigent patient with the authority, and ending when that claimhas been finally decided. [Amended by 1953 c.399 §3; 1959 c.676 §1; 1965 c.376 §3;1969 c.260 §4; 1983 c.45 §2; 2009 c.595 §805]
445.100 [Repealed by1965 c.376 §6]
445.110Hospital claims; form and contents. Each claim shall be made in writing inthe form prescribed by the Oregon Health Authority, and shall show, and beaccompanied by, the following matters and things:
(1)The name and last-known post-office address of the person to whom care has beengiven.
(2)The number of days’ care, with the dates of admission to the hospital and ofdischarge therefrom or other termination of care.
(3)The amount of the claim.
(4)A statement in writing showing the effort made by the hospital to collect theamount of the claim, the facts indicating the indigency of the patient, and theamount, if any, of money received from the patient or others in payment of theaccount of the patient.
(5)If reasonably obtainable, the affidavit of the indigent patient or of theperson or agency, if any, responsible for the patient, and, if reasonablyobtainable, the statement in writing of a public or private agency engaged inthe relief of the poor, verifying the indigency of the patient. If theaffidavit or statement does not accompany the claim, and it is alleged in theclaim that such absence is owing to the fact that the affidavit or statement isnot reasonably obtainable, the claim shall set forth the facts upon which suchassertion is based.
(6)Any other information and data the authority may reasonably require. [Amendedby 1965 c.376 §4; 1983 c.45 §3; 1985 c.279 §7; 2009 c.595 §806]
445.120Filing of claims generally; combining claims. (1) The claim of a claimantother than a hospital shall be in form and substance like that provided in ORS445.110 in so far as applicable and be accompanied by the same supportingdocuments. However, only one set of supporting documents need be filed inrespect of any one indigent patient in regard to any one motor vehicle injury.
(2)An account for the services of an orthodontist for orthodontia performed by theorthodontist on the order of the doctor in charge of the case or an account forcare supplied by a nurse, pharmacy, ambulance operator, supplier of prostheticappliances and services or services of a licensed physical therapist may be,with the consent of the doctor, assigned to, and included as a part in and ofthe claim of, a hospital or doctor. [Amended by 1969 c.260 §5; 1973 c.141 §4]
445.130Effect of liability of third person or commencement of legal action onsettlement of claim.For the purposes of claims under ORS 445.110 and 445.120, an indigent patientwho is not otherwise able to pay the charges for care supplied shall not bedeemed to be able to pay them because a third person might be held liable in anaction to recover damages on account of the motor vehicle injury, if an actionhas not been commenced. If an action has been commenced, the claim shall showthat fact. In that event the Oregon Health Authority may suspend thedetermination of the claim until the action has been terminated and from timeto time require the claimant to supply such further information and data inrespect of the action as the authority may deem necessary in order to determinethe ultimate ability of the patient to pay the charges for which the claim isfiled. [Amended by 1985 c.279 §8; 2009 c.595 §807]
445.140Audit and determination of validity of claims. The OregonHealth Authority shall examine and audit each claim filed with it under thischapter. From the information and data contained in the claim, the reports ofthe claimant, the documents so accompanying and supporting the claim and suchother evidence as it may reasonably require or itself adduce, the authorityshall find and determine:
(1)Whether or not the claim has been filed within the time limited in ORS 445.090.
(2)Whether or not the claim is predicated upon care supplied to a person sufferingfrom a motor vehicle injury.
(3)Whether or not the injured person is unable to pay the charges for which theclaim is filed, within the meaning of ORS 445.020.
(4)Whether or not the claimant has made reasonable and timely effort to effectcollection of its claim. [Amended by 1969 c.260 §6; 1985 c.279 §9; 2009 c.595 §808]
445.150Order allowing or rejecting claim; notice. (1) If, in the matter of theclaim, the Oregon Health Authority finds and determines in the affirmative inrespect of items listed in ORS 445.140, the authority shall, by its order madeand filed in the matter, allow the claim in such amount, not exceeding thelimitations in ORS 445.060 and 445.070, less such amount as has been paid onthe account.
(2)If in its judgment the maintenance of the solvency of the Motor VehicleAccident Fund so requires, the authority may make payment in monthlyinstallments of any claim which has been allowed by it, or finally adjudgedaffirmatively by a court on appeal.
(3)If the authority finds and determines in the negative in respect of any itemlisted in ORS 445.140, the authority shall, by its order made and filedtherein, reject the claim.
(4)The authority promptly shall serve the claimant with a copy of its order,addressed to the claimant at the claimant’s last-known post-office address asshown by the records and files of the authority. [Amended by 1983 c.45 §5; 1983c.740 §116; 1985 c.279 §10; 2009 c.595 §809]
445.155Judicial review.Judicial review of regulations under ORS 445.050 and orders under ORS 445.150shall be in accordance with ORS chapter 183, provided that the amount involvedin the appeal from the order exceeds $100, and provided further that the amountinvolved in the appeal from the decision of the court exceeds $500. [1971 c.734§62]
445.160 [Repealed by1971 c.734 §21]
445.170 [Repealed by1985 c.279 §14]
445.180Reassignment of rights to claimant on notice of finding person liable for care. (1) If it comesto the knowledge of a claimant who has received payment of a claim under thischapter that the patient in respect of whom the claim has been paid, or anyother person chargeable by law with the care or support of the patient, hasbeen paid, or is able to pay, the amount of the claim, the claimant shalldiligently pursue such payment.
(2)A claimant who has received payment of a claim from the Oregon Health Authorityunder this chapter shall inform the authority promptly and in writing if:
(a)The claimant receives any payment from or on behalf of the patient in respectof whom the claim has been paid or from any person chargeable by law with thecare or support of the patient;
(b)The claimant knows or has reason to believe that the patient or any personchargeable by law with the care or support of the patient is able to pay theamount of the claim or any part thereof; or
(c)The claimant or any person on behalf of the claimant institutes an actionagainst the patient or any person chargeable by law with the care or support ofthe patient to recover all or part of the amount of the claim.
(3)All moneys paid to or for the use or benefit of the claimant by or on behalf ofthe patient shall, after deduction of the reasonable cost of recovering them,be paid to the authority for deposit in the Motor Vehicle Accident Fund. [Amendedby 1985 c.279 §11; 2009 c.595 §810]
445.185When deduction may be made from payments on claim. When a claimantfails to pursue payment as required by ORS 445.180 or to pay to the OregonHealth Authority the amount required by ORS 445.180 to be paid, the authorityshall, after 60 days, deduct the amount paid by it on the claim from anysubsequent payment made to the claimant unless it is made to appear to thesatisfaction of the authority that:
(1)Upon due and diligent search and inquiry neither the patient nor any personchargeable by law with the care or support of the patient can be found;
(2)An action against the patient or a person chargeable by law with the care orsupport of the patient has been instituted and is pending; or
(3)An action has been prosecuted to final judgment, all legal remedies forsatisfaction of the judgment have been exhausted and the judgment has not beencollected. [1985 c.279 §13; 2009 c.595 §811]
445.190 [Repealed by1985 c.279 §14]
445.200 [Repealed by1985 c.279 §14]
445.210 [Repealed by1985 c.279 §14]
445.220 [Repealed by1985 c.279 §14]
445.230 [1961 c.470 §2;repealed by 1985 c.279 §14]
445.240 [1961 c.470 §3;1983 c.45 §4; repealed by 1985 c.279 §14]
445.250 [1961 c.470 §4;repealed by 1985 c.279 §14]
445.260 [1961 c.470 §5;repealed by 1985 c.279 §14]
445.270 [1983 c.126 §3;repealed by 2009 c.595 §1204]
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