§ 414.324 — Prohibition on requiring prior authorization or step therapy for human immunodeficiency virus drugs

Oregon § 414.324

• Jurisdiction: Oregon
• Vol.: 11
• Title 34: Human Services; Juvenile Code; Corrections
• Ch. 414: Medical Assistance

Text

(1) As used in this section:
(a) “Prior authorization” has the meaning given that term in ORS 743B.001.
(b) “Step therapy” has the meaning given that term in ORS 743B.001.
(2) Notwithstanding ORS 414.325, the Oregon Health Authority and a coordinated care organization may not require prior authorization or step therapy for drugs prescribed for a medical assistance recipient for the treatment or prevention of human immunodeficiency virus if:
(a) The drug has been approved by the United States Food and Drug Administration for the treatment or prevention of human immunodeficiency virus; and
(b) The prescribing provider has determined that the drug is medically necessary.
(3) Nothing in this section prevents the authority or a coordinated care organization from performing drug utilization review that may be necessary for patient safety or for ensuring the prescribed drug is medically accepted as required by section 1927 of the Social Security Act of 1935 (42 U.S.C. 1396r-8).

Legislative History

2025 c.480 §5