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OregonHB 40402026 Regular SessionHouseWALLET

Relating to health care; and declaring an emergency.

Sponsored By: Sponsor information unavailable

Became Law

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Bill Overview

Analyzed Economic Effects

36 provisions identified: 24 benefits, 1 costs, 11 mixed.

Broader coverage for prosthetics and orthotics

Health plans that cover hospital or medical care must cover medically necessary prosthetic and orthotic devices. Plans must also cover fittings, instruction, supplies, repair, and replacement when needed. The device must be the right model to support daily living, work, and physical activity like running or swimming. Managed care plans must include at least two different Oregon prosthetic/orthotic providers in‑network.

Anesthesia must be covered, any length

For plans issued, renewed, or extended on or after January 1, 2027, your health plan must cover medically needed anesthesia for any covered procedure, no matter how long it lasts. Insurers cannot deny payment just because anesthesia went past a preset time limit.

Hospitals must pause collections during appeals

If you appeal a hospital’s decision, the hospital must stop all collection actions while your appeal is pending. If a collection agency has your bill, the hospital must tell them to pause collections too. This protects you from new collection activity during the appeal.

Licensed clinicians may offer psilocybin services

Health professionals who also hold a psilocybin facilitator license may lead preparation and integration sessions. They may conduct administration sessions if they do not provide other health care during those sessions. Licensing boards cannot discipline a provider for discussing psilocybin or, if properly licensed, for providing psilocybin services. Oregon will also accept approved out‑of‑state facilitator training that meets Oregon’s standards.

Medicaid coverage during and after custody

If you live in a correctional facility, your medical assistance is suspended, not ended. A facility designee may apply for benefits on your behalf to set up full coverage at release or during a hospital stay outside the facility. When the agency is told you are released or hospitalized outside, it reinstates the benefits you are eligible for at that time.

Faster answers and clearer comp notices

Insurers must accept or deny your claim in writing within 60 days after your employer learns of it. The acceptance notice must list covered conditions, say if it is disabling, and explain your rights, including job help. After you give written notice of an aggravation or a new or omitted condition, the insurer has 60 days to accept or deny. If a notice seems wrong or leaves out a condition, you must first object in writing and give the insurer 60 days to clarify or fix it. When a claim closes, you get a detailed closure notice and 60 days to ask the director to reconsider; the insurer has seven days to ask for reconsideration.

Faster workers’ comp pay and penalties

Your first temporary disability payment is due within 14 days after your employer knows of your claim and disability and your doctor approves it, and then at least every two weeks. If a self‑insured employer keeps paying your regular wages on your normal schedule, those count as timely disability payments. If an insurer unreasonably delays or refuses payment or a claim decision, you can get up to 25% extra of amounts due plus attorney fees (generally capped at $4,000 and adjusted yearly). When repaying an overpayment, no more than 25% can be taken from each temporary or total disability check unless you agree.

Nurse practitioners can manage injured workers’ care

A nurse practitioner or physician associate who is not in your managed care network can act like your primary care provider for a work injury. They must keep your records, have treated you before, agree to send you to the managed care group for specialty care, and follow that group’s rules. This can make it easier to keep seeing a familiar provider.

Quicker access to vocational help

You qualify for vocational help if you cannot return to your old job or any suitable job with your employer, you have a substantial handicap from the injury, and a suitable job pays at least 80% of your regular weekly wage. Your insurer must contact you within five days when you may be eligible or when you are medically stationary. Within 30 days after that contact, a certified person must evaluate you and give a decision. When requested, your attending doctor has 20 days to do or refer a physical capacities test or explain in writing if you cannot take it.

Stronger payment rules for dental offices

Starting January 1, 2028, dental insurers must pay the provider directly for covered care. Insurers can use card or EFT payments that charge fees only if they give advance notice, offer a no‑fee option, and the provider chooses the fee method. Insurer refund “clawbacks” face strict timelines: generally within your contract period or 18 months after payment, 45 days for coordination of benefits, and limits on when contested refunds can be demanded.

Drug affordability reviews and equity guardrails

Each year, the Prescription Drug Affordability Board reviews up to nine drugs and may review at least one insulin for affordability. It looks at Oregon price, rebates, how many people use the drug, out‑of‑pocket costs, access, and equity, and hears from patients and experts. The board cannot use quality‑adjusted life‑years or similar tools that discount care for older or disabled people and must weigh quality of life the same for all when a drug extends life.

Generic drugs and tighter travel pay

For compensable prescriptions, pharmacists must dispense generic drugs when allowed by law, which usually lowers medicine costs. Travel reimbursement to see your attending doctor is capped at what it would cost to see a same‑specialty doctor closer to your home. In a metro area, all attending doctors are treated as in the same medical community. The cap does not apply if your care is under a managed care contract.

More hospital bill help and refunds

Hospitals must screen uninsured patients, people on state medical help, and those who owe over $1,500 for one visit for financial help before billing. The state sets rules so the quick check needs no documents, does not hurt credit, and hospitals apply any help before sending a bill and explain appeals. You can apply later if you were not screened or disagree, and for up to 12 months after you paid. If you were eligible then, the hospital must refund the amount and, if it wrongly denied you, pay Federal Reserve interest and reasonable costs and fix any sold debt. Once approved with documents, your eligibility lasts nine months. Hospitals may ask for documents only when you file a formal application after the quick check.

Paid parent caregivers with worker protections

The state runs a program to pay parents who give attendant care to children assessed with very high medical or behavioral needs. Agencies must hire parent providers as employees, not contractors, and pay overtime the same as other direct support staff. Agencies generally cannot pay for services during normal school hours unless the child is temporarily home recovering. The department must set rules with an advisory committee to protect nonparent caregivers, require training and background checks, allow a child to object to a caregiver, centralize appeals, and prevent duplicate payments. Program funding and details depend on department rules.

Who can treat and certify claims

More provider types can serve as your attending physician, including physicians, podiatrists, oral surgeons, nurse practitioners, and physician associates. Chiropractors and naturopathic doctors may be your attending doctor only for up to 60 days or 18 visits on the initial claim. Only your attending physician at claim closure can make impairment findings. Physical therapists need your attending doctor’s OK or a managed care contract to provide compensable care. Nurse practitioners must certify they reviewed required materials before giving compensable services or approving disability.

Attending physician controls return‑to‑work rights

Beginning March 3, 2026, only your attending physician’s release counts as presumptive proof you can return to regular or suitable work. Nurse practitioner releases no longer control reinstatement or reemployment rights. For state workers, the state keeps group health coverage until listed events that must be determined by the attending physician. For unemployment base‑year extensions tied to workers’ comp, only an attending physician’s release counts, and you must file by the fourth week of unemployment and within three years of the injury.

Stricter rules on workers’ comp payments

Your insurer can stop temporary disability pay if your attending physician does not confirm you cannot work after they ask, unless you could not get treatment for reasons beyond your control. If you miss an appointment and then miss the rescheduled one after certified notice, pay can be suspended until you go. An attending physician’s services are not paid until needed verification is sent. A doctor can backdate disability only 45 days, with narrow exceptions; and pay can stop when an authorization period ends until it is renewed. If you are in a managed care plan and keep seeing a nonauthorized doctor more than seven days after notice, all compensation can be suspended. Training‑time disability pay is capped at 16 months, with possible extension up to 21 months. Before ending pay, the insurer must send written notice, and a doctor may backdate up to 45 days before that notice (or further if the notice was late and reauthorized in time).

New workers’ comp duties for employers

You must report any accident that may lead to a compensable claim to your insurer right away and within five days. If you fail to report on time and your insurer is penalized, you must reimburse the insurer for that penalty. You may choose to pay small, nondisabling medical bills up to a cap (base $1,500, adjusted each year by the medical CPI and rounded to $100) without hurting your experience rating. The insurer still decides if benefits are owed.

Faster decisions on dental claims

Dental insurers must pay or deny a clean claim within 45 days of getting it. If they need more info, they must tell the patient and provider within 45 days. After they get the extra info, they again have 45 days to pay or deny. This starts January 1, 2028.

Easier path to residential administrator license

You can qualify to be a residential care facility administrator with two of the last five years in a professional or manager job in health or social services, a mix of experience and education the office accepts, or a bachelor’s degree in any field. These changes take effect January 1, 2027.

Easier retired status for naturopaths

Starting January 1, 2027, naturopathic license holders who are 65 and retired (or retiring next year) can be excused from annual continuing education. They may also convert to retired license status at age 65 if they meet board rules and pay any required fees.

Faster reports from your injury doctors

Attending doctors must send the first injury report to the insurer or self‑insured employer within 72 hours after the first service. Rules also require follow‑up reports and audits to keep claims moving. When your attending doctor changes, the new doctor must notify the insurer within five days, and referrals to consulting doctors must be reported quickly.

Public officials’ salary counts as disability pay

If you hold a public office and are hurt on the job, your full official salary counts as on‑time temporary disability pay while it continues. You do not need a separate disability check from the insurer during that period.

Pilot to review insurance mandates

The Legislative Policy and Research Director creates a standard impact statement for insurance mandate bills. The pilot covers up to three Senate and three House measures from 2025. A draft report is due September 15, 2026, and final statements and a process report are due December 15, 2026. By September 15, 2027, the Director recommends how to improve mandate reviews, and may propose new laws or request resources.

Psilocybin rules change in 2027

Changes to Oregon’s psilocybin laws take effect January 1, 2027. The Oregon Health Authority and licensing boards can act before that date so they are ready to carry out the new duties on and after January 1, 2027.

More Medicaid recipients on advisory board

For a short time, the committee must include more Medicaid recipients: at least 10% until July 9, 2026, and at least 20% from July 10, 2026 to July 9, 2027. Starting July 10, 2027, the committee includes four Medicaid recipients, including one person with a disability and one who qualifies based on modified adjusted gross income. The temporary quota section ends January 2, 2028.

More openness in Oregon health reviews

The Health Evidence Review Commission’s agendas and recommendations must be posted at least 14 days before meetings. Written public comments must be posted and sent to commissioners within 48 hours after comment closes, unless there are over 50 comments. The commission must send its prioritized services list by July 1 of even‑numbered years, and each list lasts two years starting no earlier than October 1 of odd‑numbered years. Starting July 10, 2027, Medicaid Advisory Committee terms are three years.

Naturopathic board changes start 2027

Changes to naturopathic licensing and related rules take effect January 1, 2027. The board may act before that date to be ready to carry out its duties.

More Oregon dental rotation options

Starting January 1, 2027, out‑of‑state dental students in accredited programs can do clinical or community rotations in Oregon. Rotations must follow Oregon Board of Dentistry rules and be under indirect supervision by accredited program faculty. This opens more training sites in Oregon.

Workers’ comp moves to e‑filing

The director can allow or require electronic filing of workers’ comp reports, claims, and proof of coverage. The board can allow electronic filings and notices under its authority. This modernizes how insurers and employers send required documents.

Some pharmacy admin groups exempt from license

A pharmacy services administrative organization does not need a third‑party administrator license if it is not owned by a pharmacy benefit manager and only earns monthly service fees that are not tied to drug price or volume. The exemption applies only while these conditions are met.

Tighter rules for paid parent caregivers

To be paid, a parent must work as a direct support professional or a personal support worker and cannot be paid by an agency they or family own or run. During paid one‑on‑one care hours, the parent cannot be responsible for a vulnerable adult or another child under 10 unless another caregiver is right there. Paid tasks must mainly benefit the client child or be listed in the child’s support plan.

Claim closure review and medical arbiters

You get one reconsideration of a claim closure, and the director finishes it in 18 working days. The director can add up to 60 calendar days if a medical arbiter is used and may delay up to 45 days for active settlement talks. The medical arbiter can examine you and order tests, and the insurer pays those costs. Not cooperating with the arbiter can suspend your benefits and close the review record.

One older insurance law repealed

The law repeals ORS 743B.221. The effect depends on how people and agencies used that section before.

Ban on quality-of-life scores

The Health Evidence Review Commission cannot use general “quality of life” measures when judging if a service is cost‑effective, recommended, or its value. This also stops relying on studies that use those measures. An exception in other law may apply.

Psilocybin centers must report deidentified data

Starting January 1, 2027, licensed psilocybin service centers must collect and submit quarterly, deidentified client and service data to the Oregon Health Authority. The data includes demographics, session types, denials, adverse reactions, and average doses. Clients may ask that their information not be submitted. The Authority may exempt data that cannot be safely deidentified, ban sale of the data, and share it with OHSU for evaluation.

Sponsors & Cosponsors

Sponsors

There is no primary sponsor on record.

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 138 • No: 1

Senate vote • 3/5/2026

Third reading. Carried by Patterson. Passed.

Yes: 27 • No: 1

House vote • 3/3/2026

Third reading. Carried by Nosse. Passed.

Yes: 55 • No: 0

legislature vote • 2/27/2026

Ways and Means: Heard and Reported Out

Yes: 48 • No: 0

House vote • 2/12/2026

Health Care: Heard and Reported Out with Amendments

Yes: 8 • No: 0

Actions Timeline

  1. Chapter 109, (2026 Laws): Effective date April 7, 2026.

    4/13/2026House

  2. Governor signed.

    4/7/2026House

  3. President signed.

    3/10/2026Senate

  4. Speaker signed.

    3/10/2026House

  5. Third reading. Carried by Patterson. Passed.

    3/5/2026Senate

  6. Second reading.

    3/4/2026Senate

  7. Recommendation: Do pass the A-Eng. bill.

    3/4/2026Senate

  8. Referred to Ways and Means.

    3/3/2026Senate

  9. First reading. Referred to President's desk.

    3/3/2026Senate

  10. Third reading. Carried by Nosse. Passed.

    3/3/2026House

  11. Second reading.

    3/2/2026House

  12. Recommendation: Do pass.

    2/27/2026House

  13. Work Session held.

    2/27/2026House

  14. Returned to Full Committee.

    2/25/2026House

  15. Work Session held.

    2/25/2026House

  16. Assigned to Subcommittee On Human Services.

    2/18/2026House

  17. Referred to Ways and Means by order of Speaker.

    2/16/2026House

  18. Recommendation: Do pass with amendments, be printed A-Engrossed, and be referred to Ways and Means.

    2/16/2026House

  19. Work Session held.

    2/12/2026House

  20. Public Hearing held.

    2/10/2026House

  21. Public Hearing held.

    2/5/2026House

  22. Referred to Health Care.

    2/2/2026House

  23. First reading. Referred to Speaker's desk.

    2/2/2026House

Bill Text

  • Enrolled

    3/6/2026

    PDF

  • A-Engrossed

    2/16/2026

    PDF

  • House Amendments to Introduced

    2/16/2026

    PDF

  • HHC Amendment -11 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -12 (Proposed)

    2/12/2026

    PDF

  • HHC Amendment -13 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -14 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -15 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -16 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -17 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -19 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -24 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -25 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -3 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -30 (Proposed)

    2/12/2026

    PDF

  • HHC Amendment -32 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -33 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -34 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -35 (Proposed)

    2/12/2026

    PDF

  • HHC Amendment -36 (Adopted)

    2/12/2026

    PDF

  • HHC Amendment -6 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -7 (Combined)

    2/12/2026

    PDF

  • HHC Amendment -27 (Proposed)

    2/10/2026

    PDF

  • HHC Amendment -10 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -11 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -13 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -14 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -15 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -16 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -17 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -18 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -19 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -21 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -3 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -6 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -7 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -8 (Proposed)

    2/5/2026

    PDF

  • HHC Amendment -9 (Proposed)

    2/5/2026

    PDF

  • Introduced

    1/28/2026

    PDF

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