OR HB3134

Insurers must report expanded prior authorization data to the Department of Consumer and Business Services, including approval/denial percentages for standard and expedited requests, appeals outcomes, and average/median processing times, to be published on the department's website by March 1 annually

Providers may perform medically necessary additional or related procedures discovered during an authorized surgery without obtaining separate prior authorization, provided the procedure is a covered benefit and not experimental

Insurers must implement a prior authorization application programming interface (API) conforming to 45 C.F.R. 156.223(b) that allows providers to check authorization requirements, identify needed documentation, and submit requests through electronic health records systems (effective January 1, 2027)

Insurers must respond to prior authorization requests submitted through the API using the same API system

The bill amends ORS 743B.001, 743B.250, 750.055, and 750.333 to incorporate these requirements into Oregon's Insurance Code for health benefit plans, health care service contractors, and multiple employer welfare arrangements