OR HB3725

Extends the timeframe for health care providers to contest insurer refund requests from 30 days to six months, and prohibits insurers from electronically withdrawing funds directly from provider bank accounts for refunds

Requires insurers to provide utilization review criteria to behavioral health providers in writing in advance, rather than only upon request, and mandates written disclosure when conducting medical management techniques including the type, purpose, and legal basis for the review

Expands annual reporting requirements for carriers providing behavioral health benefits to include denial rates, appeal outcomes, in-network vs. out-of-network claim percentages, and reimbursement rates compared to Medicare rates for various provider types

Establishes the Mental Health Parity Ombudsman within the Department of Consumer and Business Services to investigate complaints, provide public education, and assist providers in disputes regarding mental health parity law compliance, with $500,000 appropriated for the 2025-2027 biennium

Adds a representative of behavioral health care providers to the Health Insurance Exchange Advisory Committee and declares the act an emergency effective upon passage, with ombudsman provisions operative January 1, 2026