Department increases maximum medical reimbursement to $1,900 for 2015

In Oregon, an employer may reimburse its workers’ compensation insurer for medical services costs on a non-disabling claim, up to a maximum reimbursement amount set by the Oregon Workers’ Compensation Division. The insurer is then prohibited from modifying the employer’s experience rating, to the extent of medical costs reimbursed on the claim. See ORS 656.262(5).

On an annual basis, the Division determines the maximum amount of reimbursable medical costs and issues a bulletin informing the industry of any change in the reimbursement maximum. Insurers must provide notice to insured employers prior to each policy year, advising of the right to reimburse medical services costs up to the maximum amount for accepted, non-disabling claims. See OAR 436-060-0055(2).

On September 3, 2014, the Division issued Bulletin 345, increasing the maximum reimbursement amount to $1,900 for 2015. Accordingly, for medical-only claims occurring on or after January 1, 2015, an employer may reimburse its workers’ compensation insurer up to $1,900, per claim, for medical services costs without any impact on its experience rating.