Oregon Finalizes SB 822 Rules: New Quantitative Network Adequacy Standards for All Health Plans

OR| Oregon‘s Permanent Administrative Order ID 6-2026 implements SB 822 by updating Oregon’s network adequacy rules to apply quantitative, federally aligned access standards to all individual, small, and large group health benefit plans, effective January 1, 2026. It adopts the federal Qualified Health Plan network adequacy framework in 45 C.F.R. 156.230 as the baseline standard, defines key terms (including carrier, low‑income ZIP code, HPSA, telemedicine, and CMS county classifications), and requires annual, provider‑level network adequacy reports that demonstrate compliance with travel time/distance and appointment wait‑time benchmarks, with structured justifications where gaps exist. The order repeals prior factor‑based and Medicare Advantage‑based approaches, limits the percentage of standards that may be met via telemedicine, strengthens provider directory content and accuracy requirements, and adds dedicated behavioral health network composition and reporting obligations, including detailed data on provider types, populations served, cultural/linguistic capabilities, and geographic distribution.

Click here to see OR Administrative Order ID 6-2026