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

1. Law
2. Oregon Revised Statutes
3. Financial Institutions, Insurance
4. Health Benefit Plans: Individual and Group
5. Prior authorization prohibited for first 60 days of treatment for opioid or opiate withdrawal and for post-exposure prophylactic antiretroviral drugs; exceptions.

(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.

(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. [2017 c.683 §4; 2021 c.365 §5]

Note: 743B.425 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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