Prior Authorization Reporting

All domestic insurers offering health benefit plans must submit annual reports of prior authorizations. All foreign insurers offering health benefit plans and who transacted $2 million or more in annual health benefit plan premiums in Oregon must submit annual reports of prior authorizations.

Refer to ORS 743B.250, OAR 836-053-1070, and OAR 836-053-1080 for additional details.

Reporting Instructions

Prior authorization reports are due annually by January 31 for the previous calendar year.

Prior authorization reports can be submitted through SERFF using the type of insurance (TOI) “Annual Required Reports" and the subtype of insurance (sub-TOI) “Prior Authorization." The prior authorization reporting template and the attestation of accurate information must be submitted together in order to be considered complete.

Questions?

Contact:
DFR.DataTeam@dcbs.oregon.gov

Key links

• Prior authorization reporting template [Excel file provided by DFR]
• Attestation of Accurate Information [fillable PDF provided by DFR]