Oregon WCD Proposing New Medical Treatment and Billing Rules
The Oregon Workers’ Compensation Division had a public comment meeting in November 2023 to discuss issues related to the medical fee schedule, medical services, and MCO. The agenda and minutes are included here.
From that meeting, the WCD is moving forward with proposed rules. The full proposal is here, but I have highlighted some of the more substantive changes below.
Updates appeal language for medical dispute to make the process more understandable;
Adds 14-day timeframe for MCO to provide a list of three providers willing to treat the worker;
Requires insurer to notify the worker within 30 days if a surgery certified by the MCO as reasonable/necessary will be approved;
Adds additional billing codes for arbiter examinations depending on complexity of the exam as well as makes several updates to CPT and billing codes;
If you have any comments for the WCD to consider regarding these, particularly in terms of claim processing burdens/costs or other issues, please plan on attending the February 21, 2024 rulemaking meeting or forward your comments to me and we can make sure they are provided to the WCD for consideration.
As always, please feel free to contact me with any questions or concerns regarding these or other rule changes at 503-999-9299 or .