Proposed rules

These proposed permanent rules replace the temporary rules that established a special enrollment period and set forth the filing and rating requirements and plan guidance for transitional plans in 2015 and implemented the provisions of chapter 80, Oregon Laws 2014. At this time, it is unknown whether the rules will be applied to future extensions of the transitional plans, if any.

The agency requests public comment on whether other options should be considered for achieving the rule’s substantive goals while reducing the negative economic impact of the rule on business.

Filed: July 15, 2014

Public hearing: September 17, 2014 1 p.m.

Last day for public comment: September 19, 2014

Documents

The Insurance Division proposes to adopt two new rules, OAR 836-053-0100 and 836-053-0105. These rules are necessary to implement ORS 656.247, as amended by House Bill 4104 (2014 Legislative Session). The rules compliment rules of the Workers’ Compensation Division intended to facilitate better management and payment for interim medical benefits resulting from a work-related injury or disease.

The proposed rules prohibit a carrier from imposing a waiver or exclusion in a health benefit plan for coverage of a service otherwise provided solely on the basis that the service is provided for a work-related injury or disease.

The proposed rules also establish an expedited preauthorization process for approving the provision of interim medical services. The rules also specify how payment is accomplished if a workers’ compensation claim is approved or denied.

Finally the rules clarify when a claim is deemed a “clean claim” for purposes of prompt payment of claims.

The agency requests public comment on whether other options should be considered for achieving the rule’s substantive goals while reducing the negative economic impact of the rule on business.

Filed: July 15, 2014

Public hearing: August 25, 2014, 9 a.m.

Last day for public comment: August 29, 2014

Documents

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This proposed rule allows an insurer with the consent of a claimant, to pay claims by means of a prepaid card, direct deposit system, automated teller machine card or debit card or other means of electronic transfer. 

Filed: June 13, 2014

Public hearing: July 24, 2014, 1:30 p.m., CR E, 350 Winter Street NE

Last day for public comment: July 31, 2014

Documents

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Where to send comments on proposed rules

Victor Garcia
victor.a.garcia@state.or.us

Key links

Oregon Revised Statutes