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WCD reports only one statewide denial under SB 533 in 2025
Summary
WCD deputy administrator Katie Bruins reported that in calendar year 2025 three MCOs operated statewide and only one denial or termination of a "come-along" provider was reported, affecting one worker in the Portland area; the reason cited was failure to follow the MCO's service utilization process.
Katie Bruins, deputy administrator for the workers' compensation division, delivered the SB 533 required annual report on denials and terminations of "come-along" providers for calendar year 2025.
She said three managed care organizations operated in Oregon (Kaiser, Majoris, Providence) and across those MCOs only one denial/termination was reported statewide. The single case occurred in GSA 4 (Portland area), involved a chiropractic physician and affected one worker; the stated reason was that the provider's treatment did not follow the MCO's service utilization process. "Across all three, only one denial or termination was reported statewide," Bruins said. She offered to refer technical questions to an MCO specialist joining virtually and invited committee questions.
Why it matters: SB 533 requires transparency about denials and terminations to monitor continuity-of-care protections for workers enrolled in MCOs. The low reported number may reflect limited denials, reporting differences, or other operational factors that stakeholders may want to examine further.
