Oregon § 743B.445 Application programming interface; requirements

Oregon Statutes

§ 743B.445 — Application programming interface; requirements

Oregon § 743B.445

Vol.18

Title 56Insurance

Ch. 743BHealth Benefit Plans: Individual and Group

This text of Oregon § 743B.445 (Application programming interface; requirements) is published on Counsel Stack Legal Research, covering Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Or. Rev. Stat. § 743B.445 (2026).

Text

(1)An insurer offering a health benefit plan in this state that provides utilization review or has utilization review provided on the insurer’s behalf shall utilize a prior authorization application programming interface as described in 45 C.F.R. 156.223(b), as in effect on February 28, 2024. The application programming interface shall enable a provider to:

(a)Determine whether prior authorization is required;

(b)Identify the information and documentation necessary to submit the request; and

(c)Transfer prior authorization requests and determinations from the provider’s electronic health records or practice management system through a secure electronic transmission.

(2)An insurer shall respond through the application programming interface described in subsection (1) of this section to

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(1) An insurer offering a health benefit plan in this state that provides utilization review or has utilization review provided on the insurer’s behalf shall utilize a prior authorization application programming interface as described in 45 C.F.R. 156.223(b), as in effect on February 28, 2024. The application programming interface shall enable a provider to:
(a) Determine whether prior authorization is required;
(b) Identify the information and documentation necessary to submit the request; and
(c) Transfer prior authorization requests and determinations from the provider’s electronic health records or practice management system through a secure electronic transmission.
(2) An insurer shall respond through the application programming interface described in subsection (1) of this section to a request that was submitted by a provider through the application programming interface.