ORS 656.254: Medical report forms; penalties and other sanctions; procedure for declaring health care practitioner ineligible for workers’ compensation reimbursement.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) The Director of the Department of Consumer and Business Services shall establish medical report forms, in duplicate snap-outs where applicable, to be used by insurers, self-insured employers and physicians, including in such forms information necessary to establish facts required in the determination of the claim. (2) The director shall establish sanctions for the enforcement of medical reporting requirements. Such sanctions may include, but are not limited to, forfeiture of fees and penalty not to exceed $1,000 for each occurrence. (3) If the director finds that a health care practitioner has: (a) Been found, pursuant to ORS 656.327, to have failed to comply with rules adopted pursuant to this chapter regarding the performance of medical services for injured workers or to have provided medical treatment that is excessive, inappropriate or ineffectual, the director may impose a sanction that includes forfeiture of fees and a penalty not to exceed $1,000 for each occurrence. If the failure to comply or perform is repeated and willful, the director may declare the health care practitioner ineligible for reimbursement for treating workers’ compensation claimants for a period not to exceed three years. (b) Had the health care practitioner’s license revoked or suspended by the practitioner’s professional licensing board for a violation of that profession’s ethical standards, the director may declare the health care practitioner ineligible for reimbursement for treating workers’ compensation claimants for a period not to exceed three years or the period the practitioner’s license is suspended or revoked, whichever period is the longer. (c) Engaged in any course of conduct demonstrated to be dangerous to the health or safety of a workers’ compensation claimant, the director may impose a sanction that includes forfeiture of fees and a penalty not to exceed $1,000 for each occurrence. If the conduct is repeated and willful, the director may declare the health care practitioner ineligible for reimbursement for treating workers’ compensation claimants for a period not to exceed three years. (4) Any declaration that a health care practitioner is ineligible to receive reimbursement under this chapter shall not otherwise interfere with or impair treatment of any person by the health care practitioner. (5) ORS 656.735 (4) to (6) and 656.740 also apply to orders and penalties assessed under this section. [1967 c.626 §§3,4; 1975 c.556 §40; 1979 c.839 §30; 1981 c.854 §15; 1987 c.233 §1; 1987 c.884 §27; 1995 c.94 §2; 1997 c.249 §200; 2003 c.170 §12; 2005 c.26 §7]
Administrative rules citing this section
- OAR 436-008-0040: Assessment of Civil Penalties — implements
- OAR 436-009-0010: Temporary rule language in effect until 10/04/2026. Medical Billing and Payment — implements
- OAR 436-009-0010: Temporary rule language in effect until 10/04/2026. Medical Billing and Payment — authority
- OAR 436-009-0012: Telehealth — implements
- OAR 436-009-0012: Telehealth — authority
- OAR 436-009-0090: Temporary rule language in effect until 10/04/2026. Pharmaceutical — implements
- OAR 436-010-0240: Temporary rule language in effect until 10/04/2026. Medical Records and Reporting Requirements for Medical Providers — implements
- OAR 436-010-0241: Temporary rule language in effect until 10/04/2026. Form 827, Worker’s and Health Care Provider’s Report for Workers’ Compensation Claims — implements
- OAR 436-050-0008: Requests for Hearings or Administrative Review — implements
- OAR 436-160-0445: Assessment of Civil Penalties — implements
- OAR 603-082-0010: Purpose — implements
- OAR 603-082-0020: Definitions — implements
This rule cites
- ORS 656.327 — resolved
- ORS 656.735 — resolved
Cited by
- OAR 436-001-0030: Role of the Workers’ Compensation Division
- OAR 436-009-0008: Request for Review before the Director
- OAR 436-009-0010: Temporary rule language in effect until 10/04/2026. Medical Billing and Payment
- OAR 436-009-0110: Interpreters
- OAR 436-010-0001: Purpose and Applicability of These Rules
- OAR 436-010-0008: Request for Review before the Director
- OAR 436-010-0250: Temporary rule language in effect until 10/04/2026. Elective Surgery
- OAR 436-010-0340: Sanctions and Civil Penalties
- OAR 436-015-0080: Suspension; Revocation
- OAR 436-030-0007: Administrative Review
- OAR 436-050-0008: Requests for Hearings or Administrative Review
- OAR 436-060-0008: Administrative Review and Contested Cases
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors656.html