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83rd OREGON LEGISLATIVE ASSEMBLY--2025 Regular Session
Senate Bill 699
Sponsored by Senator REYNOLDS, Representative PHAM H; Senators GELSER BLOUIN, SOLLMAN, WEBER,
Representatives ELMER, GAMBA, GOMBERG, GRAYBER, HELM, HUDSON, LEVY B, LIVELY, NELSON,
RUIZ, WALTERS, WRIGHT (Presession filed.)
SUMMARY
The following summary is not prepared by the sponsors of the measure and is not a part of the body thereof subject
to consideration by the Legislative Assembly. It is an editor’s brief statement of the essential features of the
measure as introduced.The statement includes a measure digest written in compliance with applicable readability
standards.
Digest: This Act tells health insurance to cover devices for more patients. (Flesch Readability
Score:72.6).
Expands the health insurance coverage of prosthetic and orthotic devices.
Declares an emergency, effective on passage.
A BILL FOR AN ACT
Relating to medical devices; creating new provisions; amending ORS 743A.145; and declaring an
emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 743A.145 is amended to read:
743A.145. (1) As used in this section:
(a) “Orthotic device” means a rigid or semirigid device supporting a weak or deformed leg, foot,
arm, hand, back or neck, or restricting or eliminating motion in a diseased or injured leg, foot, arm,
hand, back or neck.
(b) “Prosthetic device” means an artificial limb device or appliance designed to replace in whole
or in part an arm or a leg.
(2) All individual and group health insurance policies providing coverage for the expenses of
hospital, medical or surgical services or supplies shall provide coverage for prosthetic and orthotic
devices. [that are medically necessary to restore or maintain the ability to complete activities of daily
living or essential job-related activities and that are not solely for comfort or convenience.] The cover-
age required by this subsection includes:
(a) Devices that are determined by the insured’s health care provider to be medically
necessary to restore or maintain the ability to complete activities of daily living or essential
job-related activities.
(b) Devices that are determined by the insured’s health care provider to be medically
necessary and the most appropriate model that meets the medical needs of the insured for
purposes of performing physical activities, including but not limited to running, biking,
swimming and strength training, and that maximizes the insured’s whole-body health, in-
cluding lower and upper limb function.
(c) All services and supplies medically necessary for the effective use of a prosthetic or orthotic
device, including design formulation, fabrication, material and component selection, measurements,
fittings, static and dynamic alignments and patient instruction in the use of the device.
(3) The Director of the Department of Consumer and Business Services shall adopt and annually
NOTE:Matter in boldfaced type in an amended section is new; matter [italic and bracketed] is existing law to be omitted.
New sections are in boldfaced type.
LC 1089 SB699
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update rules listing the prosthetic and orthotic devices covered under this section. The list shall be
no more restrictive than the list of prosthetic and orthotic devices and supplies in the Medicare fee
schedule for Durable Medical Equipment, Prosthetics, Orthotics and Supplies, but only to the extent
consistent with this section.
(4) The coverage required by subsection (2) of this section may be made subject to, and no more
restrictive than, the provisions of a health insurance policy that apply to other benefits under the
policy.
(5) The coverage required by subsection (2) of this section shall include any repair or replace-
ment of a prosthetic or orthotic device that is [determined medically necessary to restore or maintain
the ability to complete activities of daily living or essential job-related activities and that is not solely
for comfort or convenience] described in subsection (2)(a) or (b) of this section.
(6) If the coverage under subsection (2) of this section is provided through a managed care or-
ganization, the insured shall have access to medically necessary clinical care and to prosthetic and
orthotic devices and technology from not fewer than two distinct Oregon prosthetic and orthotic
providers in the managed care organization’s provider network.
(7) An individual or group health plan may not deny a prosthetic or orthotic benefit for
an insured with limb loss or absence to restore or maintain the ability to perform a physical
activity if a benefit would be covered for medical or surgical intervention for a person with-
out limb loss or absence to restore or maintain the ability to perform the same physical ac-
tivity.
[(7)] (8) This section is exempt from ORS 743A.001.
SECTION 2. The amendments to ORS 743A.145 by section 1 of this 2025 Act apply to
policies or certificates of health insurance issued, renewed or extended on or after the ef-
fective date of this 2025 Act.
SECTION 3.This 2025 Act being necessary for the immediate preservation of the public
peace, health and safety, an emergency is declared to exist, and this 2025 Act takes effect
on its passage.
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