OAR 410-133-0000: Purpose

(1) School-Based Health Services (SBHS) rules: (a) Define Oregon’s fee-for-service Medicaid program administered by the Oregon Health Authority (Authority) to reimburse publicly funded education agencies for health services provided in education settings to Oregon’s Medicaid-enrolled children and young adults. (b) Define when Medicaid-covered services are reimbursable to education agencies. (c) Define the reimbursement methodology for services rendered in education settings. (d) Cite and align with federal and state requirements and limitations including: (A) Individuals with Disabilities Education Act (IDEA); (B) Section 504 of the Rehabilitation Act of 1973; (C) Title XIX and Title XXI of the Social Security Act; (D) Oregon Revised Statutes; and (E) Oregon Administrative Rules (OARs). (2) These SBHS rules are to be used in conjunction with: (a) Medical Assistance Programs rules in OARs Chapter 410, Divisions 120 and 141; (b) The Authority provider rules in OARs Chapter 943, Division 120; and (c) Oregon Department of Education’s (ODE) rules in: (A) OARs Chapter 581, Divisions 15, 21, and 22; and (B) OARs Chapter 584, Divisions 220 and 245. (3) Medicaid-enrolled children and young adults retain the ability to obtain services from any qualified Medicaid provider. These rules do not require Medicaid-enrolled children and young adults to receive their health services only from school medical providers.