OR DFR Bulletin 2026-03: 2026 Network Adequacy Reporting Requirements for Low-Income Zip Codes and Health Professional Shortage Areas (HPSAs)

1 Oregon Department of Consumer and Business Services Division of Financial Regulation, Bulletin No. DFR 2026-3 TO: All carriers offering individual or group health benefit plans in Oregon DATE: June 22, 2026 RE: 2026 Network Adequacy Reporting Requirements for Low-Income Zip Codes and Health Professional Shortage Areas (HPSAs) I. PURPOSE The purpose of this bulletin is to establish the official low-income zip code and Health Professional Shortage Area (HPSA) lists for the 2026 plan year. OAR 836-053-0310 requires the Division of Financial Regulation to publish these lists annually. Carriers must use these specific data sources to complete annual network adequacy reporting. II. AUTHORITY • ORS 731.016 • ORS 731.244 • ORS 743B.505 • OAR 836-053-0310 III. DEFINITIONS “Low-Income Zip Code” means a zip code included in the Centers for Medicare and Medicaid Services (CMS) Marketplace low-income zip code list for the applicable plan year, as published by CMS. “Health Professional Shortage Area” means a geographic area, population group, or facility designated as such by the Department of Health and Human Services under 42 U.S.C. § 254e. IV. REQUIRED DATA SOURCES Low-Income Zip Codes: The department adopts the plan year 2026 CMS Marketplace Low-income Zip Code list to establish the standard for the 2026 reporting year. This list is searchable here: https://dfr.oregon.gov/business/reg/health/Pages/annual-network-adequacy.aspx 350 Winter St. NE, Rm 410, PO Box 14480, Salem, OR 97309 503-947-7694 dfr.oregon.gov 2 Health Professional Shortage Areas: To identify geographic areas, population groups, or facilities designated as HPSAs, carriers must use the official tool maintained by the Health Resources and Services Administration (HRSA). The current HPSA data is searchable here: https://data.hrsa.gov/topics/health-workforce/shortage-areas/hpsa-find The division will maintain this bulletin and future updates at our website at: https://dfr.oregon.gov/laws-rules/Pages/bulletins.aspx This bulletin is effective upon issuance. 6/20/2026 TK Keen, Administrator Date Insurance Commissioner Division of Financial Regulation Department of Consumer and Business Services