For 2024, Oregon passed legislation regulating Pharmacy Benefits Managers and legislation addressing recipients of medical assistance.  The state also considered bills to deal with 340B drugs, financial transparency of hospitals, control of medical professional corporations, and certificate of need, all of which ultimately died.

Oregon is one of several states seeking to rein in healthcare costs by establishing cost growth targets. The state committee charged with designing such a program provided its recommendations to lawmakers, and they have since updated the law to implement the program. Oregon is also experimenting with health delivery and payment reform, directing various state agencies to conduct studies on the feasibility of alternative health care delivery financing and coordinated care models that reward quality over volume of patients.

Oregon is also a leader in promoting healthcare price transparency with a state-run APCD and comprehensive mandatory reporting statues for hospitals and other facilities. The state offers its residents strong surprise billing protections, requiring insurers to provide enrollees reasonable cost estimates for most non-emergency care provided both in-network and out-of-network and capping patient costs for out-of-network emergency services at in-network rates. Oregon also requires telehealth coverage for video visits, with fuller coverage required for some diabetes care.

Additionally, to address the rising cost of prescription drugs, under Oregon’s “Prescription Drug Price Transparency Act,” when the price of a medicine rises more than 10 percent, a drug maker must report the reasons to the Oregon Department of Consumer and Business Services, including information about cost of production, marketing and research. Manufacturers face civil penalties of up to $10,000 per day for failure to comply. In addition to mandating new disclosures by drugmakers and insurers, the law creates a task force that will develop a strategy for greater transparency across the entire supply chain of pharmaceutical products.

With respect to competition, the state has long required prior notice of nonprofit healthcare transactions and additionally provides statutory authority for attorney general review and approval of such transactions based on a broad set of criteria that include public interest and antitrust review.