Oregon 2025 Regular Session

Oregon Senate Bill SB699

Introduced
1/13/25  
Refer
1/17/25  
Report Pass
4/15/25  
Engrossed
4/17/25  
Refer
4/23/25  
Report Pass
5/19/25  
Enrolled
5/21/25  
Passed
6/3/25  
Chaptered
6/11/25  

Caption

Relating to medical devices.

Summary

SB 699 expands and clarifies Oregon’s health insurance coverage requirements for prosthetic and orthotic devices, renaming the covered items more broadly as “devices” and specifying what must be included in coverage. The bill requires individual and group health plans that cover hospital, medical, or surgical services to cover medically necessary devices used to restore or maintain activities of daily living or essential job-related activities, along with related services and supplies needed for effective use. It also expressly covers medically necessary replacement and repair, and adds coverage for devices that are the most appropriate model for physical activities such as running, biking, swimming, and strength training when they maximize whole-body health and limb function. The bill also directs the Department of Consumer and Business Services to adopt and annually update a list of covered devices, with the list no more restrictive than the Medicare fee schedule for durable medical equipment, prosthetics, orthotics, and supplies, to the extent consistent with the statute. It requires managed care plans to provide access to medically necessary clinical care and devices from at least two distinct Oregon prosthetic and orthotic providers in-network. The bill applies to policies or certificates issued, renewed, or extended on or after January 1, 2026, and it creates an exception for Public Employees’ Benefit Board and Oregon Educators Benefit Board plans unless those plans opt in. The bill’s impact on state law is to amend ORS 743A.145 and strengthen mandated insurance benefits for people who use prosthetic and orthotic devices, including people with limb loss, impairment, or absence. It also limits insurers’ ability to deny coverage for physical-activity-related prosthetic or orthotic benefits when comparable medical or surgical interventions would be covered for a person without limb loss. In practical terms, the measure expands access to advanced, activity-specific, repair, and replacement coverage while setting standards for network access and administrative rules. The general sentiment around SB 699 appears strongly favorable. It passed the Senate 29-0 after a committee do-pass recommendation with amendments, and it passed the House 49-0 after a House committee do-pass vote. The unanimous votes suggest broad bipartisan support and little visible opposition in the recorded legislative history. No major contention is reflected in the available materials, but the bill’s most notable policy choices are the expanded coverage for athletic and high-function prosthetic/orthotic devices, the requirement that insurers cover the most appropriate model for the insured’s needs, and the network-access mandate for managed care plans. The carve-out for PEBB and OEBB plans unless they opt in may also reflect a compromise or limitation to address public employee benefit administration and cost concerns.

Impact

SB 699 amends ORS 743A.145 to broaden and clarify mandated health insurance coverage for prosthetic and orthotic devices, including medically necessary repairs, replacements, related services, and certain activity-specific devices. It also requires rulemaking by the Department of Consumer and Business Services and applies the new requirements to policies renewed or issued on or after January 1, 2026, while exempting PEBB and OEBB plans unless they elect coverage.

Sentiment

The bill appears to have enjoyed broad, bipartisan support throughout the legislative process. It received unanimous or near-unanimous committee and floor votes in both chambers, with no recorded dissent in the provided voting history. The available record suggests the measure was viewed as a straightforward health coverage expansion rather than a controversial policy change.

Contention

No significant opposition is reflected in the provided transcripts or votes. The main policy issues embedded in the bill are the scope of required coverage for advanced or athletic prosthetic and orthotic devices, insurer standards for medical necessity and replacement, and the requirement that managed care networks include at least two Oregon providers. The exemption for Public Employees’ Benefit Board and Oregon Educators Benefit Board plans unless they opt in may have been a practical compromise to limit immediate fiscal or administrative impacts.

Companion Bills

No companion bills found.

Similar Bills

AZ HB2899

health insurance; coverage; prosthetic device

NM HB38

WHEELCHAIR INSURANCE COVERAGE

AZ HB2333

insurance; prosthetics; orthotics; reporting requirements

MA S811

To improve outcomes for those with limb loss and limb difference

MA H4549

To improve outcomes for persons with limb loss and limb difference

MA H1178

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NH SB132

Relative to health insurance coverage for prosthetics.

LA HB477

Modifies provisions of law regarding health insurance coverage of prosthetic and custom orthotic devices and services (OR INCREASE EX See Note)