ORS 411.402: Procedures for verifying eligibility for medical assistance; rules.
Edition: 2025 EditionEffective: 2026-01-01Last verified: 2026-09-07
(1) The Department of Human Services and the Oregon Health Authority shall adopt by rule, consistent with federal requirements, the procedures for verifying eligibility for medical assistance, including but not limited to all of the following: (a) The department and the authority shall access all relevant state and federal electronic databases for any eligibility information available through the databases. (b) The department and the authority shall verify the following factors through self-attestation: (A) Pregnancy; (B) Date of birth; (C) Household composition; and (D) Residency. (c) The department and the authority may not use self-attestation to verify citizenship and immigration status. (d) The department and the authority may require the applicant to provide verification in addition to the verification specified in this subsection only if the department and the authority are unable to obtain the information electronically or if the information obtained electronically is not reasonably compatible with information provided by or on behalf of the applicant. (e) The department and the authority shall use methods of administration that are in the best interests of applicants and recipients and that are necessary for the proper and efficient operation of the medical assistance program. (2) Information obtained by the department under this section may be shared with the authority and with other state or federal agencies for the purpose of: (a) Verifying eligibility for medical assistance, participation in the exchange or other health benefit programs; (b) Establishing the amount of any tax credit due to the person, cost-sharing reduction or premium assistance; (c) Improving the provision of services; and (d) Administering health benefit programs. [Formerly 414.049; 2010 c.73 §4; 2011 c.720 §102; 2013 c.14 §4; 2013 c.688 §42; 2021 c.569 §15]
Administrative rules citing this section
- OAR 410-115-0015: Eligibility and Enrollment. — implements
- OAR 410-115-0015: Eligibility and Enrollment. — authority
- OAR 410-115-0045: CCO Administration of OHP Bridge – Basic Health Program; OHP Bridge Enrollment and Choice of CCO. — implements
- OAR 410-115-0045: CCO Administration of OHP Bridge – Basic Health Program; OHP Bridge Enrollment and Choice of CCO. — authority
- OAR 410-200-0010: Overview. — authority
- OAR 410-200-0100: Coordinated Eligibility and Enrollment Process with the Department of Human Services and the Federally Facilitated Marketplace — authority
- OAR 410-200-0105: Hospital Presumptive Eligibility — authority
- OAR 410-200-0110: Application and Renewal Processing and Timeliness Standards — authority
- OAR 410-200-0111: Authorized Representatives — implements
- OAR 410-200-0111: Authorized Representatives — authority
- OAR 410-200-0115: HSD Medical Programs—Effective Dates — authority
- OAR 410-200-0120: Notices — authority
- OAR 410-200-0125: Acting on Reported Changes — authority
- OAR 410-200-0130: Retroactive Medical — authority
- OAR 410-200-0200: Residency Requirements — authority
- OAR 410-200-0205: Concurrent and Duplicate Program Benefits — authority
- OAR 410-200-0210: Requirement to Provide Social Security Number — authority
- OAR 410-200-0215: Citizenship and Non-Citizen Status Requirements — implements
- OAR 410-200-0215: Citizenship and Non-Citizen Status Requirements — authority
- OAR 410-200-0225: Assignment of Rights — implements
- OAR 410-200-0225: Assignment of Rights — authority
- OAR 410-200-0230: Verification — authority
- OAR 410-200-0235: Changes That Must Be Reported — authority
- OAR 410-200-0305: Eligibility Determination Group — Health System Division Medical Programs. — authority
- OAR 410-200-0310: Eligibility and Budgeting; Health Systems Division Medical Programs. — authority
- OAR 410-200-0315: Standards and Determining Income Eligibility — implements
- OAR 410-200-0315: Standards and Determining Income Eligibility — authority
- OAR 410-200-0400: Specific Requirements; Breast and Cervical Cancer Treatment Program (BCCTP) — authority
- OAR 410-200-0405: Specific Requirements; Substitute Care — authority
- OAR 410-200-0407: Specific Requirements; Former Foster Care Youth Medical Program — authority
- OAR 410-200-0410: Specific Requirements; MAGI CHIP — authority
- OAR 410-200-0415: Specific Requirements; MAGI Child — authority
- OAR 410-200-0420: Specific Requirements; MAGI Parent or Caretaker Relative — authority
- OAR 410-200-0425: Specific Requirements; MAGI Pregnant Woman — authority
- OAR 410-200-0435: Specific Requirements; MAGI Adult — authority
- OAR 410-200-0437: Specific Requirements: OHP Bridge - Basic Medicaid. — implements
- OAR 410-200-0437: Specific Requirements: OHP Bridge - Basic Medicaid. — authority
- OAR 410-200-0438: Specific Requirements: OHP Bridge – Basic Health Program — implements
- OAR 410-200-0438: Specific Requirements: OHP Bridge – Basic Health Program — authority
- OAR 410-200-0521: Unwinding Period - HSD Medical Programs — implements
- OAR 410-200-0521: Unwinding Period - HSD Medical Programs — authority
This rule cites
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Official source: https://www.oregonlegislature.gov/bills_laws/ors/ors411.html