OAR 410-120: Medical Assistance Programs

58 rules in Division 120, Chapter 410 (Oregon Health Authority, Health Systems Division: Medical Assistance Programs).

  1. OAR 410-120-0000: Acronyms and Definitions
  2. OAR 410-120-0001: Interpreter Services
  3. OAR 410-120-0003: OHP Standard Benefit Package
  4. OAR 410-120-0006: Medical Eligibility Standards
  5. OAR 410-120-0025: Administration of Division of Medical Assistance Programs, Regulation and Rule Precedence
  6. OAR 410-120-0030: Children’s Health Insurance Program
  7. OAR 410-120-0035: Public Entity
  8. OAR 410-120-0045: Applications for Medical Assistance at Provider Locations
  9. OAR 410-120-0250: Managed Care Entity
  10. OAR 410-120-1140: Verification of Eligibility and Coverage
  11. OAR 410-120-1160: Medical Assistance Benefits and Provider Rules
  12. OAR 410-120-1180: Medical Assistance Benefits: Out-of-State Services
  13. OAR 410-120-1190: Medically Needy Benefit Program
  14. OAR 410-120-1200: Excluded Services and Limitations
  15. OAR 410-120-1210: Medical Assistance Benefit Packages and Delivery System
  16. OAR 410-120-1215: Fee-for-Service Care Coordination: Administration
  17. OAR 410-120-1221: Fee-for-Service Care Coordination: Identification of Open Card Member Needs
  18. OAR 410-120-1225: Fee-for Service Care Coordination: Service Coordination
  19. OAR 410-120-1260: Provider Enrollment
  20. OAR 410-120-1280: Billing
  21. OAR 410-120-1285: Recoupment and Data Sharing with Third-Party Insurers
  22. OAR 410-120-1295: Temporary rule language in effect until 01/16/2027. Non-Participating Provider
  23. OAR 410-120-1300: Timely Submission of Claims
  24. OAR 410-120-1320: Authorization of Payment
  25. OAR 410-120-1340: Payment
  26. OAR 410-120-1350: Buying-Up
  27. OAR 410-120-1360: Requirements for Financial, Clinical and Other Records
  28. OAR 410-120-1380: Compliance with Federal and State Statutes
  29. OAR 410-120-1385: Compliance with Public Meetings Law
  30. OAR 410-120-1390: Premium Sponsorships
  31. OAR 410-120-1395: Program Integrity
  32. OAR 410-120-1396: Provider and Contractor Audits
  33. OAR 410-120-1397: Recovery of Overpayments to Providers — Recoupments and Refunds
  34. OAR 410-120-1400: Provider Sanctions
  35. OAR 410-120-1460: Type and Conditions of Sanction
  36. OAR 410-120-1510: Fraud and Abuse
  37. OAR 410-120-1560: Provider Appeals
  38. OAR 410-120-1570: Claim Re-Determinations
  39. OAR 410-120-1580: Provider Appeals — Administrative Review
  40. OAR 410-120-1600: Provider Appeals — Contested Case Hearings
  41. OAR 410-120-1855: Client’s Rights and Responsibilities
  42. OAR 410-120-1860: Contested Case Hearing Procedures
  43. OAR 410-120-1865: Denial, Reduction, or Termination of Services
  44. OAR 410-120-1875: Agency Hearing Representatives
  45. OAR 410-120-1880: Contracted Services
  46. OAR 410-120-1920: Institutional Reimbursement Changes
  47. OAR 410-120-1940: Interest Payments on Overdue Claims
  48. OAR 410-120-1960: Payment of Private Insurance Premiums
  49. OAR 410-120-1980: Requests for Information and Public Records
  50. OAR 410-120-1990: Telehealth
  51. OAR 410-120-2000: HRSN Services Delivery
  52. OAR 410-120-2005: Temporary rule language in effect until 10/27/2026. HRSN Service Eligibility; Identifying HRSN Eligible Members; HRSN Outreach and Engagement Services.
  53. OAR 410-120-2010: Temporary rule language in effect until 10/27/2026. HRSN Service Requests
  54. OAR 410-120-2015: Temporary rule language in effect until 10/27/2026. HRSN Eligibility Screening.
  55. OAR 410-120-2020: Temporary rule language in effect until 10/27/2026. Authorization of HRSN Services; Referral to HRSN Service Provider.
  56. OAR 410-120-2025: HRSN Person-Centered Service Plan (PCSP)
  57. OAR 410-120-2030: HRSN Service Provider Qualifications
  58. OAR 410-120-2035: Temporary rule language in effect until 12/31/2026. HRSN Rent and Utility Financial Assistance Benefit Transfer