New Medical Services Rules Proposed by the OR WCD
On February 19, 2025, the WCD is holding a hearing to propose amendments to several medical services rules in OAR 436-009, 436-010, and 436-015. Many of the amendments are to address billing code issues and remove outdated notice language. However, there are several notable proposals:
OAR 436-009-0010 would be amended to include Platelet Rich Plasma Injections as a compensable medical service for specific anatomical areas and conditions. Currently, PRP injections are excluded from compensable medical services and insurers are not required to pay for them.
There are several proposed amendments to OAR 436-009-0110 regarding interpreter services for medical appointments. Of note, insurers would not have to pay for interpreter services provided by a medical provider’s employee unless the employee is a health care interpreter certified or qualified by the Oregon Health Authority and is employed by the provider solely to provide interpreter services. Healthcare providers would also be required inform the worker of their right to choose an interpreter prior to offering interpreter services by a health care interpreter employed by the provider.
The proposed amendment to OAR 436-009-0080 would allow a licensed audiologist to prescribe certain hearing aids without the approval of an attending provider.
OAR 436-010-0270 would be amended to (1) require the insurer or their representative to respond to a medical provider’s inquiry about claim status, accepted conditions, or MCO enrollment within two days, (2) disallow the insurer or its representative from referring the medical provider to another entity to obtain an answer, and (3) allow an insurer or its representative and the medical provider to agree to communicate about claim status, accepted conditions, or MCO enrollment via email.
The hearing is open to the public both in person and remotely. For more information on how to attend see here.
SBH will be watching the proposed rule changes closely, so keep an eye out for another blog post covering which proposals are adopted. If you have any questions about the proposed rule changes or about medical services rules generally, please feel free to contact me at or 503-595-6115.
Posted by Hannah Teig.