[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6058339,"mediaKeyId","3297402-3cd35049172519df0f62f9b553d0932f","parentId",3297402,"title","Committee hears bipartisan push to reform prior authorization; bill would increase transparency and require electronic tools","audioSeconds",1014,"startMs",3063000,"endMs",4077000,"viewUrl","/Search/View?dp=1&key=3297402-3cd35049172519df0f62f9b553d0932f&start=3063&end=4077","thumbnailUrl","https://assets.pipeline.soar.com/3297402-3cd35049172519df0f62f9b553d0932f/thumbnail_3063000.jpg","articleUrl","/articles/6058339/Oregon/Committee-hears-bipartisan-push-to-reform-prior-authorization-bill-would-increase-transparency-and-require-electronic-tools","mediaUrl","https://secure.pipeline.soar.com/6058339-485e46bcffb2bed9e51adbb440ba71ed/orig.mp4?Expires=1775860556&Signature=WS47phjC5f52A0CPhrCrWgwYXTlNrHzmqvkXJUUFUYxW~ongnD6W25pC3mVTVw~5DMBFsbykKndkxXmFOK7hIbxhq4IKE491donWQ7FzzUu1hqvreExWZcq3eYZM3PYzvOrgxutFTkI1FsJEinP5eFHgNMvOI1zYzD6Zj6~~nRiB0uFPQIserz2Xo297aQVgpjXDQgGVmOb4g4zxg2kDehF4vukYV7n1MDPQGWTLRVUo69-s5w3-0wRAsnSeessssi6oL1sJjeDRR1PIuzhgpCy9iLJAxLU4b5ZWgs2K5bLfy0LBXDc~RHUed9pnyk2Ell52xOoc6G9FI6O2jPXkFw__&Key-Pair-Id=KUT5TJCACFTXG","author","Oregon Legislature","date","2025-05-13T00:00:00Z","article","The Senate Committee on Health Care held a public hearing on House Bill 3134 A, a measure that supporters described as a targeted reform to prior authorization (PA) processes used by insurers.

The bill’s sponsors and medical association representatives told the committee PA often delays medically necessary care, pushes patients to abandon treatment and heightens clinician administrative burden. The measure would make three principal changes: (1) require the Department of Consumer and Business Services to publish aggregated prior authorization data the department already collects; (2) ensure insurers reimburse medically necessary or emergent procedures discovered during surgery even if they were not preapproved at the time of booking; and (3) require insurers to adopt an electronic interface that indicates whether PA is required and which documents must be submitted, thereby aligning state practice with a federal electronic PA rule being phased in through 2027.

Why it matters: PA is a common utilization management tool across commercial insurance. Advocates say electronic approaches and reporting would reduce delays and administrative costs for clinicians and patients; insurers and plans said they support modernization but urged careful implementation to preserve appropriate utilization safeguards.

Testimony summaries
- Alex Fahlman, chief of staff to Representative Rob Nosse, framed the bill as a narrowed, practical package after broader drafts were pared back. He summarized the three core components: public reporting by DCBS of PA data it already collects; reimbursement protections for unanticipated but medically necessary intra‑operative procedures; and a phased alignment with federal electronic PA requirements that take effect in 2027.
- Courtney Dresser of the Oregon Medical Association said physician surveys (2018 and 2024) show overwhelming clinician experience of PA delays and abandonment of treatment (she cited “99 percent of Oregon physicians report prior authorization delaying patient care” and that “92 percent say it leads to patients giving up on treatment altogether”) and urged support for incremental reforms now with additional work in the interim.
- Payers including PacificSource and Blue Cross Blue Shield provided neutral testimony and emphasized the importance of careful change management and electronic interoperability; they said they will provide aggregated data to DCBS and that the department will publish aggregated results rather than raw plan‑level details.
- CareOregon raised a related matter about Medicaid coordinated care organizations and asked the committee to consider a narrow amendment allowing CCOs to reverse a prior‑authorization denial after consulting the requesting provider (a reconsideration process distinct from the formal appeals process), to reduce administrative burden brought on by federal timeline changes.

Next steps
The committee heard broad stakeholder support for transparency and for the federal electronic PA alignment; staff noted the bill passed the House unanimously and that proponents and insurers will continue technical work during the interim and through rulemaking and implementation timelines tied to federal requirements in 2027.

Ending note
Sponsors described the bill as a practical step toward reducing delays and administrative costs associated with prior authorization while aligning Oregon law with forthcoming federal electronic PA standards.","mediaType","Video","parentTitle","Senate Committee On Health Care 05/13/2025 3:00 PM","oneSentenceSummary","The Senate Committee on Health Care held a public hearing on House Bill 3134 A, a measure that supporters described as a targeted reform to prior authorization processes used by insurers.","taxTitle","Health Care, Senate, Committees, Legislative, Oregon","taxId",17872,"location","Oregon","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6058343,"FQHCs and pharmacies press for clearinghouse model to replace 340B claim modifiers; pharma voices concerns",3945,1934000,5879000,"/Search/View?dp=1&key=3297402-3cd35049172519df0f62f9b553d0932f&start=1934&end=5879","https://assets.pipeline.soar.com/3297402-3cd35049172519df0f62f9b553d0932f/thumbnail_1934000.jpg","/articles/6058343/Oregon/FQHCs-and-pharmacies-press-for-clearinghouse-model-to-replace-340B-claim-modifiers-pharma-voices-concerns","https://secure.pipeline.soar.com/6058343-d012e6a9aabad897e69ba3fcf3199148/orig.mp4?Expires=1775860556&Signature=LUH6QPQ2PDYqWiQuRUNrbehoEfSQs4FFkA-mkBF3ItArZ84xfXwwyfQWUqNoLFqcAKJmEFZVYYTMoaiEirlT5LPDoXpw-JHMSl1xzm91f-55Js4BEABNRVSDCKZ2sgLfYVPwVtCucaCgLsP4gddyz0eaiVZJ4ORJSAIV9l-DPfqIAHNOoVDUlc9bnm6KMO8uKRMLkYwozc8KP3bCMQ5IaQnx6YRRA5h1k3NfdR1CmefdGKGw9-PX1pdP840W0Hmr~bh18cG1VSQL2wFXkT1ery9QWl8xKIRUqGg-LVryaAyauKvXfqKskyV3s~aPTs6OscFrplLTzd~yGFxWJ0Zjyg__&Key-Pair-Id=KUT5TJCACFTXG","House Bill 3409 A drew a packed public hearing and sharply divided testimony Tuesday as federally qualified health centers, pharmacies and advocates asked the Senate Committee on Health Care to allow a neutral third‑party clearinghouse to determine whether a prescription qualifies for 340B discounts rather than requiring pharmacies to apply a claims modifier.

Proponents told the committee the current modifier‑based approach is administratively burdensome, causes back‑office rework and delays prescriptions at retail counters. They urged the committee to permit covered entities to use a clearinghouse that would match claims data across prescribers, pharmacies and payers so eligibility can be determined at or soon after point‑of‑sale.

Why it matters: Under the currently prevalent practices, pharmacists sometimes must reopen and resubmit claims after learning a drug was 340B‑eligible, administrative work that proponents say is time consuming and error prone. Supporters say a clearinghouse model — used for Medicaid in Oregon — would be faster, reduce pharmacy wait times and produce better, consistent data accessible to manufacturers and PBMs for reconciliation.

Key testimony and arguments
- Representative Rob Nosse’s office (Alex Fahlman testified) and Representative Nosse described the bill’s aim as reducing administrative burden and improving transparency through a neutral clearinghouse process used elsewhere in Medicaid systems.
- Marty Carty of the Oregon Primary Care Association said the clearinghouse would be a neutral third party and noted the state already uses a clearinghouse (GainWell Technologies) for Medicaid duplicate‑discount prevention; proponents have contracted with private clearinghouses for commercial claims reconciliation.
- Marcus Cox, pharmacy director for Klamath Health Partnership, said the modifier process is “burdensome for our pharmacies” and sometimes “close to impossible” for contract pharmacies.
- Pharmaceutical Research and Manufacturers of America (PhRMA) and other industry witnesses opposed the bill in written and oral testimony, saying the clearinghouse model is not yet proven in the commercial market, that third‑party intermediaries are already extracting large fees from the program and that state action could undercut federal reforms and best practices.
- Patient advocates warned that adding new intermediaries can divert resources away from patient services; one patient advocate noted the program’s original intent was to benefit patients and urged careful consideration before shifting arrangements.

Conflict‑of‑interest and neutrality concerns
Proponents told the committee the bill includes conflict‑of‑interest protections so that PBMs could not simultaneously act as the neutral clearinghouse for the same entities. Witnesses cautioned that if a vendor were functionally connected to a PBM, it would undermine neutrality; proponents said a well‑defined wall between business lines can address that concern and indicated the bill’s language disallows clearinghouses that are PBMs.

Data and cost questions
Committee members repeatedly asked for clear, quantifiable accounting of how much third‑party vendors and contract pharmacies earn on 340B transactions and how much could shift to clearinghouse vendors. Witnesses representing FQHCs said they could not provide a single statewide percentage but argued that administrative savings and fewer claim resubmissions would be a fraction of total 340B discounts and would free resources for patient care. Industry witnesses pointed to federal reports showing billions in fees to intermediaries and urged caution.

Next steps
The committee held robust testimony and did not immediately vote on the measure. Members asked proponents and opponents to confer to clarify conflict‑of‑interest language, data access and the financial flows that would fund a neutral clearinghouse; staff noted that additional paperwork and amendments may follow.

Ending note
Supporters described the bill as a technical fix to a time‑consuming process that would mirror Medicaid practice in Oregon; opponents said it risks enabling third‑party intermediaries to extract more program value. The committee kept the record open to reconcile those competing concerns.","House Bill 3409 A drew a packed public hearing and sharply divided testimony Tuesday as federally qualified health centers, pharmacies and advocates asked the Senate Committee on Health Care to allow a neutral third‑party clearinghouse to determine 340B eligibility instead of requiring pharmacies to apply claims modifiers.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6058334,"Bill would let Oregon hospitals receive real‑time sickle cell care protocols in ERs; supporters say it could reduce delays and harm",681,2352000,3033000,"/Search/View?dp=1&key=3297402-3cd35049172519df0f62f9b553d0932f&start=2352&end=3033","https://assets.pipeline.soar.com/3297402-3cd35049172519df0f62f9b553d0932f/thumbnail_2352000.jpg","/articles/6058334/Oregon/Bill-would-let-Oregon-hospitals-receive-realtime-sickle-cell-care-protocols-in-ERs-supporters-say-it-could-reduce-delays-and-harm","https://secure.pipeline.soar.com/6058334-fb01db20e5714fdb1b440cd7b27d03b0/orig.mp4?Expires=1775860556&Signature=Gyo8BiqK5jL4iBSYdgo3X0lSkeVfa8b5S3dLg5l0Q9HDOfFd0QAyKYXZSx-emsBoq6h7v6fwdlwXegrBvox8KNkWpBEbryrvpZqmMYd-HbokEiq9zM8i5ocog4gB4wL3yqQNLQjytjf8Aj4T5SAucdGxPf49cfa6AlXfyrUIQ8S8uI7eEMB2Bb8smtspKcqONTbBA197W1Puy5mJwrcEIIS0CJU-6VyuNA1GwA3Xc7~NdKIShWuXNgXCt0IcDmvGPEcDsdQsT7Xci3QXUisx3-Jc3xiKEpQHBqPnjVhJYt8NsaGBnFzgPKbRGFH~6bkJwiuA4RHoBR9ClfJO6nf2gA__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Committee on Health Care heard testimony on House Bill 2940 A, which would direct the Oregon Health Authority to implement a program using an existing emergency department notification system to deliver real‑time alerts and individualized care protocols for patients with sickle cell disease.

Supporters, including the bill sponsor and the Hospital Association of Oregon, said the program would reduce dangerous delays in emergency care for a patient population that emergency clinicians may see infrequently and that sometimes faces disbelief about the severity of their pain.

Why it matters: Sickle cell crises can produce extreme, acute pain and rapid organ deterioration. Supporters argued that many emergency departments do not see sickle cell cases frequently enough to retain experience in treatment, so providing individualized protocols and a direct link to hematologists can improve timeliness and appropriateness of care.

Testimony highlights
- Representative Travis Nelson (testifying) said the bill “has the power to ease suffering and save lives” and described the condition’s risks, individualized protocols and the need for real‑time specialist consultation in the emergency setting.
- Travis Mavison, director of government affairs for the Hospital Association of Oregon, described the Emergency Department Information Exchange (EHDI) as an established web‑based and EHR‑integrated tool that provides real‑time alerts when statewide criteria are triggered and allows sending providers to upload care guidelines for specific patient needs. He said the bill would use existing systems and urged support.

Operational questions and limits discussed
Committee members asked whether the EHDI system is accessible to first responders and whether this functionality duplicates or complements electronic health records. Witnesses said EHDI is integrated with many EHRs and that the notification system ensures cross‑hospital alerts, particularly valuable when a patient goes to a different emergency department than their primary care or usual hospital. Witnesses said EHDI notifications are triggered at check‑in based on predefined criteria (recent frequent ED use, security events, etc.) and that sending providers can include brief, focused care guidelines, not a complete medical history.

Next steps
Supporters urged the committee to advance the bill as a targeted step to reduce disparities and prevent harm, particularly for patients of color who face disproportionate morbidity. Committee members asked for implementation details about EHDI use and interoperability with ambulance systems; witnesses said EHDI is currently ED‑focused.

Ending note
Advocates and hospital representatives described the bill as a modest, pragmatic fix that leverages existing technology to deliver critical, individualized information to emergency clinicians.","The Senate Committee on Health Care heard testimony on House Bill 2940 A, which would direct the Oregon Health Authority to implement a program using the Emergency Department Information Exchange to deliver real‑time alerts and individualized care protocols for patients with sickle cell disease.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6058347,"Senate panel advances bill targeting 340B practices after hours of amendments and debate",961,877000,1838000,"/Search/View?dp=1&key=3297402-3cd35049172519df0f62f9b553d0932f&start=877&end=1838","https://assets.pipeline.soar.com/3297402-3cd35049172519df0f62f9b553d0932f/thumbnail_877000.jpg","/articles/6058347/Oregon/Senate-panel-advances-bill-targeting-340B-practices-after-hours-of-amendments-and-debate","https://secure.pipeline.soar.com/6058347-7c61be670a9b1c24d917222934501e9c/orig.mp4?Expires=1775860556&Signature=D8H7BW7tbkE-V7laRCtYXakoAvTY~P1d3C-7bp9xkVtzXA0ieGYBj~69aOLxgcVspnuRBqt4LHySqWaBQ7ogfOTQmHmPC-gLpCi2YUKyuhtDYgsjkixzO1YL3Op4Fi6TBZdXgpJAalmv7LxafNtvuJNh8YnAnIOYBBhtlU0f0GhavsLIAKq7LKAJmzL98yTPbX0gmz8swgooSY8DZ~TULtnpXywKLWf-lXruv8ioCWqfmoMTJ4MUTIJd4HABifIBc08bs9Ato0KYhT1c8JWKDvRm4rApjLMdHREheYlzhcnS20rUbpwN996uKWlNriGEkO60U1Lrg5lTGNCxuKRHEQ__&Key-Pair-Id=KUT5TJCACFTXG","The Oregon Senate Committee on Health Care advanced House Bill 2385 A on a series of contested amendment votes Tuesday, moving a measure focused on the 340B drug discount program toward the Senate floor after lengthy debate about penalties, patient benefit sharing and reporting requirements.

The bill makes it an unlawful trade practice for drug manufacturers to take specified actions that limit or interfere with a pharmacy's ability to acquire or dispense 340B drugs. Committee members debated four proposed amendments that would add a civil penalty, widen the definition of covered entities, require greater sharing of savings with low‑income patients and mandate annual reporting to the Department of Consumer and Business Services.

Why it matters: The 340B program is designed to allow qualifying health care providers to buy outpatient drugs at discounted prices so those savings can be reinvested in patient services. Critics and supporters in the hearing described the program’s growth and the role of middlemen differently: supporters argued increased transparency is necessary so discounts reach patients and safety‑net providers, while opponents warned of unintended cost shifts to hospitals, insurers and employers.

Key actions and amendments
- A proposed dash A9 amendment to define “entity” to include federally qualified health centers (FQHCs) was moved and discussed; that motion failed on a roll call vote. The motion to adopt dash A9 did not pass.
- A proposed dash A10 amendment that would have required covered entities to use 95% of the difference between payments received and acquisition cost to lower out‑of‑pocket costs for households at or below 400% of the federal poverty guideline failed on a roll call vote.
- The committee adopted a dash A8 amendment authorizing the State Board of Pharmacy to impose civil penalties of up to $5,000 per day on a manufacturer that violates provisions of the measure; the motion to adopt dash A8 passed on a roll call. During debate several members expressed concern that adding civil penalties would change previously described minimal fiscal impacts to indeterminate.
- The committee ultimately moved House Bill 2385 A, as amended, to the floor with a due‑pass recommendation; a member announced an intention to file a minority report.

Discussion highlights
Committee members pressed two related themes through the debate: (1) transparency about how 340B savings are used and (2) the distributional consequences of changing the program. A committee member said the program “was originally designed to benefit the patients,” and others argued that without public reporting, stakeholders can’t evaluate whether savings are reaching low‑income patients or being shifted onto other payers. Opponents warned the measure — especially with civil penalties — could create tens of millions in cost to state agencies and insurers and could shift costs to hospitals and employers.

Clarifying details discussed by the committee and witnesses
- Dash A8 would authorize civil penalties up to $5,000 per day for manufacturers found in violation of the bill’s provisions.
- Dash A10 (proposed and debated but not adopted) would have required covered entities to calculate the difference between total payments received for 340B drugs and total acquisition cost and to use 95% of that difference to reduce out‑of‑pocket costs for households with incomes at or below 400% of federal poverty guidelines.
- Dash A11 (described in staff summary) would have required covered entities to report annually to the Department of Consumer and Business Services on acquisition costs, payments received and itemized efforts to lower out‑of‑pocket costs.

Next steps
The measure moved to the Senate floor with a due‑pass recommendation and a committee member said they intend to file a minority report to register dissent on the record. Committee staff noted fiscal impact and revenue statements were posted to the legislative information system prior to the meeting.

Ending note
Committee members and witnesses agreed there is room for additional work on transparency and enforcement; members urged further conversations between proponents, manufacturers and state agencies before the bill advances further.","The Senate Committee on Health Care voted to advance House Bill 2385 A, a measure aimed at restricting certain manufacturer actions around 340B drugs and increasing transparency; lawmakers debated civil penalties, low‑income patient benefits and reporting requirements before passing amendments and the bill with a due‑pass recommendation.","actionData","errors"]

Article not found

Committee hears bipartisan push to reform prior authorization; bill would increase transparency and require electronic tools

FQHCs and pharmacies press for clearinghouse model to replace 340B claim modifiers; pharma voices concerns

Bill would let Oregon hospitals receive real‑time sickle cell care protocols in ERs; supporters say it could reduce delays and harm

Senate panel advances bill targeting 340B practices after hours of amendments and debate