ORS 743B.420: Prior authorization requirements.

Except in the case of misrepresentation, prior authorization determinations shall be subject to the following requirements:

      (1) Prior authorization determinations relating to benefit coverage and medical necessity shall be binding on the insurer if obtained no more than 60 days prior to the date the service is provided.

      (2) Prior authorization determinations relating to enrollee eligibility shall be binding on the insurer if obtained no more than five business days prior to the date the service is provided.