Regulatory Alerts2025-01-01 | Bulletin 2025-4Oregon Bulletin 2025-4: Health Benefit Plan Coverage of Gender-Affirming Treatment
The Oregon Department of Consumer and Business Services issued Bulletin 2025-4 to enforce ORS 743A.325 and OAR 836-053-0441, requiring health insurers to cover medically necessary gender-affirming treatments without categorical exclusions. The bulletin establishes the World Professional Association for Transgender Health’s Standards of Care Version 8 as the minimum coverage standard and mandates network adequacy to ensure access without unreasonable delay or excessive cost-sharing. Additionally, it requires carriers to ensure that providers reviewing adverse benefit determinations complete specific training and clarifies that detransition services must be covered when medically necessary.
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