OAR 410-133-0200: Services Not Covered

(1) Oregon’s School-Based Health Services (SBHS) program does not cover or reimburse for: (a) Services that are not provided and documented by SBHS-recognized providers within their respective scope of practice and in compliance with their respective board rules, OAR 410-120-1360, and OAR 410-133-0120; (b) Unplanned services in lieu of planned services when an IPOC is required by IDEA, Section 504 of the Rehabilitation Act of 1973, or the provider’s scope of practice; (c) Record reviews as a stand-alone service; (d) Meeting preparation; (e) Report writing as a stand-alone service; (f) Correspondence (e.g., copying, mailing, etc.); (g) Purchase of an assistive technology device or software; (h) Activities related to determining Medicaid eligibility and enrollment status, administrative activities, and travel time by SBHS-recognized providers; (i) Educational workshops, training classes, and parent training workshops; (j) Regular transportation services to and from school; (k) Vocational services; (l) Services provided to non-Medicaid children or young adults; (m) Services provided by an entity that employs an excluded provider; or (n) Planned services performed on a date of service for which the child or young adult’s IPOC has lapsed. (2) Education-based costs normally incurred to operate a school and provide an education are not covered for Medicaid reimbursement by the Authority.