OR HB2029

Requires insurers and coordinated care organizations (CCOs) to provide behavioral health providers with detailed, plain-language documentation of all claim requirements, including examples and identification of requirements that may result in recoupment

Limits audit timeframes: insurers cannot audit paid claims older than 12 months (6 years for fraud), and CCOs/Oregon Health Authority cannot audit claims older than 5 years without fraud indication; audits must be completed within 180 days

Prohibits recoupment based on clerical errors, requires audits be reviewed by behavioral health professionals, and bars reversing prior medical necessity determinations or prior authorizations

Directs the Oregon Health Authority to establish an education unit to develop curriculum and training materials for providers on audit compliance, with materials posted on OHA and CCO websites

Applies to audits initiated on or after January 1, 2027, with the act taking effect on the 91st day following adjournment of the 2025 legislative session