(1) An insurer offering a health benefit plan may not:
(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 preexposure prophylactic antiretroviral drugs, or drugs prescribed for the treatment of human immunodeficiency virus or acquired immunodeficiency syndrome; 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.
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.
[2017 c.683 §4; 2021 c.365 §5; 2023 c.411 §3; 2025 c.480 §3]