ORS 743B.425 - Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs

ORS 743B.425
Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs

exceptions

(1)

An insurer offering a health benefit plan as defined in ORS 743B.005 (Definitions) may not:

(a)

Require prior authorization:

(A)

During the first 60 days of treatment, including medication therapy, prescribed for opioid or opiate withdrawal; or

(B)

For post-exposure prophylactic antiretroviral drugs or at least one preexposure prophylactic antiretroviral drug; or

(b)

Restrict the reimbursement for medication therapies, preexposure prophylactic antiretroviral drugs or post-exposure prophylactic antiretroviral drugs to in-network pharmacists or pharmacies.

(2)

This section is not subject to ORS 743A.001 (Automatic repeal of certain statutes on individual and group health insurance).

(3)

This section does not prohibit prior authorization for opioids or opiates prescribed for purposes other than medication therapy or treatment of opioid or opiate abuse or addiction.

(4)

Subsection (1)(b) of this section does not apply to a health maintenance organization as defined in ORS 750.005 (Definitions). [2017 c.683 §4; 2021 c.365 §5]

Note: 743B.425 (Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743B or any series therein. See Preface to Oregon Revised Statutes for further explanation.

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Health Benefit Plans: Individual and Group

ORS 743B.425
Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs

exceptions

(1)

(a)

(A)

(B)

(b)

(2)

(3)

(4)

Source

Health Benefit Plans: Individual and Group

ORS 743B.425 Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs exceptions

(1)

(a)

(A)

(B)

(b)

(2)

(3)

(4)

Source

ORS 743B.425
Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs

exceptions