ORS 414.072 Prior authorization data and reports

As used in this section, “coordinated care organization” has the meaning given that term in ORS 414.025.

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:

The number of requests received;

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

The number of denials that were reversed on an appeal.