OAR 410-125-0102: Medically Needy Clients

(1) The QIO can give prior authorization for non-emergency inpatient services for clients who are in the Medically Needy Program but have not yet met their spend-down. Only Medically Needy Program clients under age 21 and pregnant women have coverage for inpatient services if enrolled in the Medically Needy Program. (2) Prior authorization cannot be granted for outpatient services, which require prior authorization. However, you may contact the Division Medical/ Dental Group once the client has been made eligible and request retroactive authorization.