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Oregon lawmakers consider narrow prior‑authorization reforms to reduce delays and add electronic access
Summary
Representative Rob Nosse proposed a narrowed set of prior‑authorization reforms that would require public reporting, protect reimbursement for medically necessary additional intraoperative procedures and mandate electronic prior‑authorization interoperability.
Representative Rob Nosse described a narrowed approach to House Bill 3134 that aims to reduce administrative burden from prior authorizations while preserving appropriate utilization review. The revision (dash‑2 expected) focuses on three items: public reporting of prior‑authorization activity, reimbursement protection for additional medically necessary procedures discovered during surgery, and a requirement that insurers implement electronic prior‑authorization interfaces compatible with providers’ electronic health records.
Clarissa Boxwell, director of clinical operations at Grants Pass Clinic, told the committee staff at her clinic spend roughly 200 hours per week processing prior authorizations and that delays have concrete patient harms — including a patient who waited two weeks for a medication because the insurer erroneously flagged it as needing prior authorization, and a child who waited ten months for a safety bed.
The Oregon Medical Association, which has surveyed physicians about prior authorization burdens, urged the committee to adopt the narrower package. Courtney Dresser, OMA, said published reporting already collected by state and federal rules should be made publicly available to identify problem areas and that the CMS electronic prior‑authorization timelines (new federal rules) should be aligned with state requirements.
Insurers said prior authorization plays an important role in patient safety and cost control. PacificSource, Regence and others said they are working with bill sponsors on a dash‑2 amendment and that federal interoperability standards could substantially reduce administrative load if providers participate. PacificSource also noted state law already imposes timelines and processes for fully‑insured plans and that ERISA‑governed plans and federal programs fall outside some state authorities.
The committee closed the public hearing on HB 3134; sponsors and insurers said they would continue drafting technical language and a narrower amendment for future consideration.
