Oregon Finalizes Rule Expanding Coverage for Prosthetic and Orthotic Devices Under SB 699, Effective January 1, 2026

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OR| Oregon Department of Insurance issues permanent rule order (ID 9-2025) from the Oregon Department of Consumer and Business Services amends OAR 836-052-1000, effective January 1, 2026, to implement SB 699 by defining the list of prosthetic and orthotic devices that must be covered under ORS 743A.145, including any device with a CMS HCPCS Level II L-code as of January 1, 2025, and additional medically necessary devices that best meet an insured’s needs for physical activities and whole-body health; it prohibits internal or separate benefit limits or caps on these devices other than a permissible lifetime policy maximum, clarifies that otherwise prohibited lifetime or annual dollar limits may not be imposed, and specifies that “managed care organization” coverage includes closed-network health insurance policies requiring use of network providers.

Click here to see OR Permanent Administrative Order ID 9-2025

  • Bulletin
  • Oregon
  • Department of Insurance

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