State Overview: Oregon

State law or statute prohibits or limits the use of prior authorization for buprenorphine-containing products by either the state Medicaid plan or private insurance companies.

An insurer offering a health benefit plan may not require prior authorization during the first 60 days of treatment, including medication therapy, prescribed for opioid or opiate withdrawal. Or. Rev. Stat. §743B.425

Medicaid plans are prohibited from requiring prior authorization for the first 30 days of medication assisted treatment for substance use disorder (including opioid addiction medications). Or. Rev. Stat. §431A.463

Oregon credentials three types of addiction counselors. A Certified Alcohol Drug Counselor (CADC) I requires a high school diploma, 150 hours of relevant education courses and 1,000 hours of supervised experience. A CADC II requires a bachelor's degree, 300 hours of relevant education courses and 4,000 hours of supervised experience. A CADC III requires a graduate degree, completion of all education requirements of a CADC II education along with additional relevant courses and 6,000 hours supervised experience. Mental Health and Addiction Certification Board of Oregon and Addiction Counselor Certification Board of Oregon

Licensed professional counselors assess, diagnose and treat mental, emotional or behavioral disorders in individuals, couples, children, families, groups or organizations. Or. Rev. Stat. §675.705(7)

The certification criteria for peer support specialists are established by the Oregon Health Authority. The standards for the certification of recovery mentors, including experience, training, and supervision requirements, are developed and administered by a third-party, non-profit certification provider. Or. Admin. Rules 410-180-0300, et seq

Full independent practice and prescriptive authority.

The APRN scope of practice, including CNMs, must be congruent with population foci of educational preparation and content of the corresponding Board recognized national certification examination. For CNMs, their scope of practice is limited to the care of women focusing on pregnancy, childbirth, the postpartum period, care of the newborn, and family planning and gynecological needs of women. The APRN is independently responsible and accountable for the continuous and comprehensive management of health care.  Or. Admin. Rules §851-055-0000

A CNM may prescribe drugs, devices and Schedules II-V controlled substances. Or. Admin. Rules §851-055-0078

Full independent practice and prescriptive authority.

The APRN scope of practice, including NPs, must be congruent with population foci of educational preparation and content of the corresponding Board recognized national certification examination. The APRN is independently responsible and accountable for the continuous and comprehensive management of health care. Or. Admin. Rules §851-055-0000

An NP may prescribe drugs, devices and Schedules II-V controlled substances. Or. Admin. Rules §851-055-0078

NPs are authorized to sign POLST forms. Or. Admin. Rules §333-270-0030

A primary care provider is a physician, naturopath, nurse practitioner, physician assistant or other health professional licensed or certified in this state, whose clinical practice is in the area of primary care. Or. Admin. Rules §836-053-1505

Optometrists may use any means, other than invasive or laser surgery, for diagnosis and treatment of the human eye. They may remove lumps and bumps from the eye and its appendages. Or. Rev. Stat. §683

Optometrists may use injectables for the treatment of eye abnormalities. Or. Rev. Stat. §683

Optometrists may prescribe Schedule II hydrocodone-combination drugs and Schedule III-V controlled substances. Or. Rev. Stat. §683.010

A dental hygienist may obtain an expanded practice permit and perform unsupervised services for patients in a variety of limited access settings. The dental hygienist has limited prescriptive authority and temporary restorations and local anesthesia may be provided. The dental hygienist must complete a certain number of supervised hours and educational requirements before receiving the permit. Or. Admin. Rules §818-035-0065

A dental therapist may practice dental therapy only under the supervision of a dentist and pursuant to a collaborative agreement with the dentist that outlines the supervision logistics and requirements for the dental therapist's practice. A dental therapist may perform and provide only those procedures and services authorized by the dentist and set out in the collaborative agreement. Or. Rev. Stat. §679.600

Oregon allows for the practice of teledenistry. Medicaid reimburses for teledentistry through multiple telehealth modalities, including live video and store-and-forward. Or. Admin. Rules §410-123-1265

Oregon has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Oregon does not allow pharmacists to modify prescriptions.

A pharmacist may prescribe and administer injectable hormonal contraceptives and prescribe and dispense self-administered hormonal contraceptives. A pharmacist must complete a training program approved by the State Board of Pharmacy that is related to prescribing injectable hormonal contraceptives and self-administered hormonal contraceptives. The pharmacist must also provide a self-screening risk assessment tool that the patient must use prior to the pharmacist's prescribing the hormonal contraceptive and refer the patient to the patient's primary care practitioner or women's health care practitioner. Or. Rev. Stat. §689.689

Pursuant to a statewide drug therapy management protocol and as adopted by rule of the board of pharmacy, a pharmacist may prescribe smoking cessation therapy. The board of pharmacy may establish a formulary of drugs and devices that a pharmacist may prescribe and dispense to a patient pursuant to a diagnosis by a health care practitioner. The formulary may include smoking cessation aids. Or. Rev. Stat. §689.645

Collaboration allowed with a physician for practice and prescriptive authority.

A PA shall engage in collaboration with the appropriate health care provider as indicated by the patient, the standard of care and the physician assistant's education, experience and competence. The degree of collaboration must be determined at the PA's primary location of practice. The determination may include decisions made by a physician, podiatric physician or employer with whom the PA has entered into a collaboration agreement, or the group or hospital service and the credentialing and privileging systems of the PA's primary location of practice. Or. Rev. Stat. §677.510(2)-(5)

A PA may provide any medical service, including prescribing and administering controlled substances in Schedules II through V under the federal Controlled Substance Act that is within the scope of practice of the PA. The degree of autonomous judgment that a PA may exercise shall be determined at the PA's primary location of practice by the community standards of care and the PA's education, training, and experience. Or. Rev. Stat. §677.515(1),(3),(5)

Statute does not limit the number of PAs a physician may supervise.

A supervising physician organization may supervise any number of PAs. Or. Admin. Rules §847-050-0036(6)

Chart co-signature may be determined at the practice level.

The supervising physician, agent or the supervising physicians in the supervising physician organization must provide regular and routine oversight and chart review. Or. Admin. Rules §847-050-0037(6)

Statute does not allow adaptable proximity.

"Supervision" means the routine review by the supervising physician or designated agent, as described in the practice agreement or Board-approved practice description of the medical services provided by the physician assistant, under a practice agreement or practice description. There are three categories of supervision: (a) "General Supervision" means the supervising physician or designated agent is not on-site with the PA, but must be available for direct communication, either in person, by telephone, or other synchronous electronic means. (b) "Direct Supervision" means the supervising physician or designated agent must be in the facility when the PA is practicing. (c) "Personal Supervision" means the supervising physician or designated agent must be at the side of the PA at all times, personally directing the action of the PA. Or. Admin. Rules §847-050-0010(1), (3)-(4),(11)-(14)

The PA may perform medical services included in the collaborative agreement and that are within the PA's education and training. Or. Admin. Rules §847-050