2025 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 743B - Health Benefit Plans: Individual and Group
Section 743B.607 - Nonopioid prescription drug coverage requirements.
(1) As used in this section:
(a) "Clinically appropriate" means supported by nationally recognized compendia, clinical guidelines or generally recognized standards of care.
(b) "Compendia" means those resources widely accepted by the medical profession in the efficacious use of drugs.
(c) "Health care coverage" has the meaning given that term in ORS 743B.602.
(d) "Nonopioid prescription drug" means a drug that is prescribed for the treatment of chronic or acute pain and is approved by the United States Food and Drug Administration.
(e) "Prior authorization," "step therapy" and "utilization review" have the meanings given those terms in ORS 743B.001.
(2) An entity that provides health care coverage for prescription drugs shall ensure that the entity’s drug formulary provides coverage for at least one clinically appropriate nonopioid prescription drug as an alternative for each opioid prescription drug.
(3) The coverage described in this section for nonopioid prescription drugs may be made subject to, but may not be more restrictive than, the provisions for coverage for opioid prescription drugs, including with respect to prior authorization, step therapy, other utilization review requirements, cost-sharing, copayments, coinsurance and deductibles. [2025 c.536 §2]
Note: 743B.607 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.
