ORS 414.072: Prior authorization data and reports.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) As used in this section, “coordinated care organization” has the meaning given that term in ORS 414.025. (2) The Oregon Health Authority shall compile and annually post to the authority’s website a report of the following information, in the aggregate, that was reported to the authority by coordinated care organizations regarding requests for prior authorization received by coordinated care organizations or risk-bearing entities acting for or in concert with coordinated care organizations: (a) The number of requests received; (b) The number of requests that were initially denied and the reasons for the denials, including, but not limited to, lack of medical necessity or incomplete requests; and (c) The number of denials that were reversed on an appeal. [2021 c.154 §1]
Official history and status
History: Note: 414.072 was enacted into law by the Legislative Assembly but was not added to or made a part of ORS chapter 414 or any series therein by legislative action. See Preface to Oregon Revised Statutes for further explanation.
This rule cites
- ORS 414.025 — resolved
Cited by
No inbound citations found.
Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors414.html