| | Relating to review of certain decisions in workers' compensation claims; creating new provisions; and amending ORS 183. |
 | | A worker becomes subject to the contract upon the worker's receipt of actual notice of the worker's enrollment in the managed care organization, or upon the third day after the notice was sent by regular mail by the insurer or self-insured employer, whichever event first occurs. |
| | Enrolled House Bill 2091 (HB 2091-A) Page 10 Reasonable and necessary medical services received from sources other than the managed care organization after the date of claim denial must be paid as provided in ORS 656.248 by the insurer or self-insured employer if the claim is finally determined to be compensable. |
| | If the worker requests a hearing on such revocation of acceptance and denial, the insurer or self-insured employer must prove, by a preponderance of the evidence, that the claim is not compensable or that the insurer or self-insured employer is not responsible for the claim. |
| www.leg.state.or.us /05reg/measures/hb2000.dir/hb2091.en.html (15140 words) |
