Bill > HB3134

This bill addresses prior authorization requirements for health insurers in Oregon, introducing several key provisions. First, the bill requires insurers to allow providers to perform additional or related medical procedures during a pre-authorized surgical procedure without seeking extra prior authorization, provided the new procedure is medically necessary and covered under the patient's health plan. Second, it mandates that insurers implement an application programming interface (API) by January 1, 2027, which will enable healthcare providers to electronically determine prior authorization requirements, submit requests, and receive determinations through a secure system. The bill also updates reporting requirements for insurers, requiring them to provide more detailed statistical information about prior authorization requests, including approval and denial rates, and average processing times for both standard and expedited requests. Additionally, the bill amends several existing Oregon Revised Statutes to incorporate these new requirements and ensure they apply to various types of health insurance providers. The changes aim to streamline the prior authorization process, improve transparency, and potentially reduce administrative burdens for healthcare providers and insurers.

Health and Social Services

https://olis.oregonlegislature.gov/liz/2025R1/Measures/Overview/HB3134