2017 ORS 743.035¹
Uniform prior authorization form for prescription drug benefits
  • consultation with Oregon Health Authority
  • rules

(1) The Department of Consumer and Business Services, in consultation with the Oregon Health Authority, shall develop by rule a form that providers in this state shall use to request prior authorization for prescription drug benefits. The form must:

(a) Be uniform for all providers;

(b) Not exceed two pages;

(c) Be electronically available and transmissible; and

(d) Include a provision under which additional information may be requested and provided.

(2) If a person described in ORS 743.029 (Uniform standards for health care financial and administrative transactions) (2) requires prior authorization for prescription drug benefits, the person must allow the use of the form developed under subsection (1) of this section.

(3) An insurer meets the requirement set forth in ORS 743B.423 (Utilization review requirements for insurers offering health benefit plan) (2)(d) if the insurer answers a provider’s request for prior authorization within two business days of having received a completed form developed under subsection (1) of this section and all supporting documentation needed to process the request.

(4) The department may adopt rules to implement this section. [Formerly 743.065]

Note: 743.035 (Uniform prior authorization form for prescription drug benefits) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743 or any series therein. See Preface to Oregon Revised Statutes for further explanation.

1 Legislative Counsel Committee, CHAPTER 743—Health and Life Insurance, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors743.­html (2017) (last ac­cessed Mar. 30, 2018).
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.