justicedao/ipfs_state_laws huggingface dataset:
410-146-0080 Professional Ambulatory Services (1) Professional Ambulatory services provided by IHCP include Medical, Diagnostic, Screening, Dental, Vision, Physical Therapy, Occupational Therapy, Podiatry, Behavioral Health, Substance Use Disorder, Maternity Case Management, Speech, Hearing, and Home Health services. (2) Providers must use the following guidelines in conjunction with all individual program-specific Division administrative rules to determine service coverage and limitations for OHP clients according to their benefit packages: (a) American Indian/Alaska Native (AI/AN) Services administrative rules (OAR 410 division 146), (b) General Rules (OAR 410 division 120); (c) OHP Administrative Rules (OAR 410-141-0480, 410-141-0500, and 410-141-0520), and (d) The Health Evidence Review Commission’s (HERC) Prioritized List of Health Services (List). (3) IHS and Tribal 638 facilities may be reimbursed for covered professional services provided within the scope of the clinic and within the individual practitioner’s scope of license or certification. See also AI/AN OAR 410-146-0085. (4) The date of service determines the appropriate version of the AI/AN Services Rules, General Rules, and the HERC Prioritized List that IHCPs should use to determine coverage. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 16-2005, f. 3-11-05, cert. ef. 4-1-05 OMAP 49-2004, f. 7-28-04 cert. ef. 8-1-04 OMAP 68-2003, f. 9-12-03, cert. ef. 10-1-03 OMAP 3-2003, f. 1-31-03, cert. ef. 2-1-03 OMAP 59-2002, f. & cert. ef. 10-1-02 OMAP 45-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 6-2001, f. 3-30-01, cert. ef. 4-1-01 OMAP 25-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 2-1999, f. & cert. ef. 2-1-99
410-146-0100 Vaccines for Children (1) The Vaccines for Children (VFC) program supplies federally purchased free vaccines for immunizing eligible clients ages 0 through 18 at no cost to participating health care providers. For more information on how to enroll in the VFC program, contact the Oregon Health Authority (Authority) Immunization program. Refer to the AI/AN Supplemental Information for instructions and OAR 410-130-0255(4) VFC program. (2) The Division shall reimburse for the administration of vaccines to eligible clients according to the IHCP’s IHS or cost-based rate. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 61-2005, f. 11-29-05, cert. ef. 12-1-05 OMAP 59-2002, f. & cert. ef. 10-1-02 OMAP 45-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 2-1999, f. & cert. ef. 2-1-99
410-146-0130 Modifiers (1) The Division uses HIPAA compliant modifiers for many services. (2) The following services require the use of a modifier for all services for all procedures: (a) Family planning service -- FP, refer to OAR 410-130-0585 Family Planning Services; (b) Vaccine for children -- SL or 26, refer to OAR 410-130-0255. (3) When billing for services that are reimbursed outside an IHCP’s cost-based or IHS rate, a clinic must use the required modifier listed in the individual program-specific administrative rules. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 68-2003, f. 9-12-03, cert. ef. 10-1-03 OMAP 59-2002, f. & cert. ef. 10-1-02
410-146-0160 Administrative Medical Examinations and Reports (1) The Division may not reimburse administrative medical examinations and reports at an IHCP’s IHS encounter rate. Administrative medical examinations and reports are not eligible under the Memorandum of Agreement (MOA). The Division shall reimburse providers for Administrative Examinations and Reports on a fee-for-service basis outside the IHS or cost-based encounter rate. (2) AI/AN Health Care Facilities may be reimbursed for administrative medical examinations and reports when requested by a Department of Human Services branch office or approved by the Division. The branch office may request an Administrative Medical Examination/Report Authorization (OHP 729) to establish client eligibility for an assistance program or casework planning. (3) Refer to OAR 410 division 150, Administrative Examination and Report Billing Services, for specific requirements. See Administrative Exams Supplemental Information guide for more detailed information on procedure codes and descriptions. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 59-2002, f. & cert. ef. 10-1-02 OMAP 45-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 25-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 2-1999, f. & cert. ef. 2-1-99
410-146-0200 Pharmacy (1) A valid encounter excludes pharmaceutical or biologicals not generally provided during a clinic visit: (a) An IHS or Tribal 638 Pharmacy may select whether to be reimbursed by the Division for prescriptions, including dispensing services, at the appropriate 340(B) or Federal Supply Schedule Acquisition Rate (refer to OAR 410-121-0160) plus the dispensing fee as determined by the state, or at the All-Inclusive Rate (AIR) published annually by the IHS, inclusive of dispensing fees; (b) An IHS or Tribal 638 Pharmacy may request to change from the appropriate 340(B) or Federal Supply Schedule Acquisition Rate plus a dispensing fee methodology, to the IHS All-Inclusive Rate (AIR) methodology, or from the IHS AIR methodology to the appropriate 340(B) or Federal Supply Schedule Acquisition Rate (AAC) plus dispensing fee methodology, but no more frequently than four times in a calendar year. Requests must be submitted at least 30 days in advance and shall be effective at the start of the following quarter. If an IHS or Tribal 638 Pharmacy experiences circumstances requiring a methodology change, the 30 day advance notice may be waived and the process. (2) IHCPs may bill directly the Division only for contraceptive supplies and contraceptive medications outside of the pharmacy program: (a) For clients enrolled with a PHP, IHCPs must bill the PHP first. If the PHP will not reimburse for the contraceptive supply or contraceptive medication, then the clinic may bill the Division fee-for-service at the clinic’s acquisition cost. See also OAR 410-130-0585, Family Planning Services; (b) For clients not enrolled with a PHP, IHCPs may bill directly the Division fee-for-service at the clinic’s acquisition cost for contraceptive supplies and contraceptive medications. See also OAR 410-130-0585, Family Planning Services. (3) Refer to OAR 410 division 121, Pharmaceutical Services program for specific information. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 24-2008, f. 6-13-08, cert. ef. 7-1-08 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 59-2002, f. & cert. ef. 10-1-02 OMAP 39-2002, f. 9-13-02, cert. ef. 9-15-02 OMAP 45-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 6-2001, f. 3-30-01, cert. ef. 4-1-01 OMAP 25-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 2-1999, f. & cert. ef. 2-1-99
410-146-0220 Death With Dignity (1) Death with Dignity is a covered service, except for those facilities limited by the Assisted Suicide Funding Restriction Act of 1997 (ASFRA), and is incorporated in the "comfort care" condition/treatment line on the HERC’s Prioritized List of Health Services. (2) All Death with Dignity services must be billed directly to the Division, even if the client is in a prepaid health plan. Death with Dignity services are not part of the AI/AN encounter rate. (3) Follow criteria outlined in OAR 410-130-0670. Statutory/Other Authority: ORS 413.042 & ORS 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017 DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 59-2002, f. & cert. ef. 10-1-02 OMAP 25-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 28-1999, f. & cert. ef. 6-4-99 OMAP 22-1999(Temp), f. & cert. ef. 4-1-99 thru 9-1-99 OMAP 2-1999, f. & cert. ef. 2-1-99
410-147-0000 Foreword (1) The Division of Medical Assistance Programs” (Division) Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) rules are designed to assist FQHCs and RHCs to deliver health care services and prepare health claims for clients with Medical Assistance Program coverage. (2) The FQHC and RHC rules contain important information including general program policy, provider enrollment, and maintenance of financial records, special programs, and billing information. (3) It is the clinic’s responsibility to understand and follow all Division rules that are in effect on the date services are provided. (4) Typically rules are modified twice a year, April for technical changes and October for technical and/or program changes. Technical changes refer to operational information. All provider rules can be found on the Division website. (5) FQHCs and RHCs must use rules contained in the FQHC and RHC rules. Do not use other provider rules unless specifically directed in rules contained in the FQHC and RHC rules. Division General Rules and the Oregon Health Plan (OHP) Administrative Rules are intended to be used in conjunction with all program rules including the FQHC and RHC provider rules. (6) The Health Services Commission’s Prioritized List of Health Services is found in the OHP Administrative Rules (OAR 410-141-0520) and defines the services covered under Division. (7) An FQHC is defined as a clinic that is recognized and certified by the Centers for Medicare and Medicaid Services (CMS) as meeting federal requirements as an FQHC. (8) An RHC is defined as a clinic that is recognized and certified by CMS as meeting federal requirements for payment for RHC services. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: OMAP 47-2005, f. 9-9-05, cert. ef. 10-1-05 OMAP 63-2004, f. 9-10-04, cert. ef. 10-1-04 OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0000 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0000 OMAP 42-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 37-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 21-2000, f. 9-28-00, cert. ef 10-1-00 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 19-1999, f. & cert. ef. 4-1-99 HR 24-1996, f. 11-29-96, cert. ef. 12-1-96 HR 13-1996(Temp), f. & cert. ef. 7-1-96 HR 24-1992, f. & cert. ef. 7-3-92 HR 12-1992, f. & cert. ef. 4-1-92 HR 33-1991, f. & cert. ef. 8-16-91, Renumbered from 461-014-0415 HR 29-1991(Temp), f. & cert. ef. 7-1-91 HR 4-1991, f. 1-15-91, cert. ef. 2-1-91 AFS 47-1989, f. & cert. ef. 8-24-89 AFS 16-1989(Temp), f. 3-31-89, cert. ef. 4-1-89 AFS 20-1988, f. 3-8-88, cert. ef. 4-1-88
410-147-0020 Professional Ambulatory Services (1) Providers must use the following rules in conjunction with all individual program rules to determine service coverage and limitations for Oregon Health Plan (OHP) clients according to their benefit packages: Medical, EPSDT, Diagnostic, Dental, Vision, Physical Therapy, Occupational Therapy, Podiatry, Mental Health, Alcohol and Chemical Dependency, Maternity Case Management, Speech, Hearing, and Home Health services are governed by the Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) rules (OAR 410 division 147), General Rules (410 division 120), OHP Administrative Rules (410-141-0480, 410-141-0500, and 410-141-0520), and the Health Services Commission's (HSC) Prioritized List of Health Services (List), and the Oregon Health Authority (Authority) rules related to provider enrollment and claiming (943-120-0300 through 0380). (2) Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) are eligible for reimbursement of covered professional services provided within the scope of the clinic and within the individual practitioner’s scope of license or certification. See also OAR 410-147-0120(6). For the purposes of this rule, a clinic's "scope" refers to authorization or certification to provide services if required: (a) For FQHCs only, services must be provided in accordance with the FQHC’s scope as approved by the Health Resources and Services Administration (HRSA) Notice of Grant Award Authorization; and (b) Both FQHCs and RHCs must provide services within the scope of the Addictions and Mental Health Division (AMH) certification for the facility, if required. See OAR 410-147-0320(3) and (5). (3) The date of service determines the appropriate version of the FQHC and RHC rules, General Rules, and HSC Prioritized List to determine coverage. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 71-2003, f. 9-15-03, cert. ef. 10-1-03 OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0140 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0500 OMAP 21-2000, f. 9-28-00, cert. ef 10-1-00 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 19-1999, f. & cert. ef. 4-1-99
410-147-0085 Client Copayments (1) The Division of Medical Assistance Programs (Division) Medical Care Identification will indicate which Oregon Health Plan (OHP) clients are responsible for copayments for services. (2) Division requires copayments from clients with certain benefit packages. See OAR 410-120-1230, Client Copayment, and Table 120-1230-1 for specific details. (3) A client may owe more than one copayment during a 24-hour period. Division may require copayments for each medical, dental, mental health or alcohol and chemical dependency encounter on the same date of service. Refer to OAR 410-147-0140, Multiple Encounters. Statutory/Other Authority: ORS 413.042 Statutes/Other Implemented: ORS 414.025 & 414.065 History: OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 49-2004, f. 7-28-04 cert. ef. 8-1-04 OMAP 71-2003, f. 9-15-03, cert. ef. 10-1-03 OMAP 3-2003, f. 1-31-03, cert. ef. 2-1-03 OMAP 90-2002, f. 12-24-02, cert. ef. 1-1-03
410-147-0160 Modifiers (1) The Division of Medical Assistance Programs (Division) uses HIPAA compliant modifiers for many services. (2) The following conditions require the use of a modifier for all codes: (a) Family Planning Service — FP, Refer to OAR 410-130-0585 Family Planning Services (b) Vaccine for Children — SL or 26, Refer to OAR 410-130-0255(4) (3) When billing for services that are reimbursed outside a clinic’s encounter rate, a clinic must use the required modifier(s) listed in the individual program Administrative Rules. (a) Enhanced Care Services (including extended care) — HK, Refer to OAR 410-147-0120; (b) Assist surgeon for cesarean deliveries for Citizenship Waived Medical (CWM) clients — 80, 81, 82 or AS. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 16-2022, minor correction filed 02/16/2022, effective 02/16/2022 DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 71-2003, f. 9-15-03, cert. ef. 10-1-03 OMAP 63-2002, f. & cert. ef. 10-1-02
410-147-0180 Vaccines for Children (VFC) Program (1) The Division of Medical Assistance Programs (Division) will reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for the administration of vaccines to eligible clients. (2) The VFC program supplies federally purchased free vaccines for immunizing eligible client’s ages 0 through 18 at no cost to participating health care providers. For more information on how to enroll in the VFC program, contact the Oregon Health Authority (Authority) Immunization Program. Refer to the FQHC and RHC Supplemental Information for instructions. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08 OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0160 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0540 OMAP 21-2000, f. 9-28-00, cert. ef 10-1-00 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 19-1999, f. & cert. ef. 4-1-99
410-147-0240 Administrative Medical Examinations and Reports (1) The Division of Medical Assistance Programs (Division) does not reimburse Administrative Medical Examinations and Reports at a clinic’s encounter rate. Division reimburses providers for Administrative Examinations and Reports on a fee-for-service basis. (2) Refer to OAR 410 division 150, Administrative Examination and Billing Services, for specific requirements. See Administrative Exams Supplemental Information for more detailed information on procedure codes and descriptions. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0220 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0620 OMAP 21-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 19-1999, f. & cert. ef. 4-1-99
410-147-0260 Death With Dignity (1) Death With Dignity is a covered service, except for those facilities limited by the Assisted Suicide Funding Restriction Act of 1997 (ASFRA), and is incorporated in the “comfort care” condition/treatment line on the Health Services Commission’s Prioritized List of Health Services. (2) All claims for Death With Dignity services must be billed directly to the Division of Medical Assistance Programs (Division), even if the client is in a managed care plan. Death With Dignity services are not part of the Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) encounter rate. (3) Follow criteria outlined in OAR 410-130-0670. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0260 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0035 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 27-1999, f. & cert. ef. 6-4-99 OMAP 21-2000, f. 9-28-00, cert. ef 10-1-00 OMAP 19-1999, f. & cert. ef. 4-1-99 OMAP 16-1999(Temp), f. & cert. ef. 4-1-99 thru 9-1-99
410-147-0280 Drugs (1) As defined by the Division of Medical Assistance Programs (Division), a valid Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) encounter excludes pharmaceutical or biologicals not generally provided during a clinic visit. Refer to OAR 41-147-0120 Division Encounter and Recognized Practitioners. (a) Because Division includes the costs of drugs or medication treatments administered by a clinic to treat a client during an office visit in the PPS all-inclusive encounter rate for the office visit, providers cannot bill separately for the costs of the drugs or treatments; (b) Prescriptions are not included in the Prospective Payment System (PPS) encounter rate. To bill for filled prescriptions, the FQHC or RHC’s qualified enrolled pharmacy must bill Division using its pharmacy provider number. (2) Clinics may directly bill Division using their clinic provider number for contraceptive supplies and contraceptive medications only for: (a) Clients enrolled in a prepaid health plan (PHP): Clinics must bill the PHP first. If the PHP will not reimburse for the contraceptive supply or contraceptive medication, then the clinic can bill Division fee-for-service at the clinic’s acquisition cost. See also OAR 410-130-0585, Family Planning Services; (b) Fee-for-service clients: Clinics can directly bill Division fee-for-service at the clinic’s acquisition cost for contraceptive supplies and contraceptive medications. See also OAR 410-130-0585, Family Planning Services. (3) Refer to OAR 410 division 121, Pharmaceutical Services Program Rulebook for specific information. Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 25-2008, f. 6-13-08, cert. ef. 7-1-08 OMAP 27-2006, f. 6-14-06, cert. ef. 7-1-06 OMAP 71-2003, f. 9-15-03, cert. ef. 10-1-03 OMAP 63-2002, f. & cert. ef. 10-1-02, Renumbered from 410-135-0240 OMAP 62-2002, f. & cert. ef. 10-1-02, Renumbered from 410-128-0600 OMAP 39-2002, f. 9-13-02, cert. ef. 9-15-02 OMAP 42-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 37-2001, f. 9-24-01, cert. ef. 10-1-01 OMAP 19-2001, f. 3-30-01, cert. ef. 4-1-01 OMAP 8-2001, f. 3-30-01, cert. ef. 4-1-01 OMAP 21-2000, f. 9-28-00, cert. ef 10-1-00 OMAP 20-2000, f. 9-28-00, cert. ef. 10-1-00 OMAP 35-1999, f. & cert. ef. 10-1-99 OMAP 19-1999, f. & cert. ef. 4-1-99
410-147-0365 Rural Health Clinic Obstetrics Care Delivery Procedures Reimbursement Reimbursement for obstetric delivery procedures by the Division of Medical Assistance Programs (Division) to eligible Medicare-certified Independent RHCs will be according to the physician fee schedule and outside of the Prospective Payment System (PPS). Statutory/Other Authority: ORS 413.042 & 414.065 Statutes/Other Implemented: ORS 414.065 History: DMAP 20-2010, f. 6-23-10, cert. ef. 7-1-10 DMAP 9-2010(Temp), f. 4-13-10, cert. ef. 5-1-10 thru 10-26-10 DMAP 20-2007, f. 12-5-07, cert. ef. 1-1-08 OMAP 44-2006, f. 12-15-06, cert. ef. 1-1-07 OMAP 64-2005, f. 11-29-05, cert. ef. 1-1-06 OMAP 48-2005(Temp), f. & cert. ef. 9-15-05 thru 2-15-06 OMAP 26-2005, f. 4-20-05, cert. ef. 6-1-05 OMAP 18-2005(Temp), f. 3-15-05, cert. ef. 3-18-05 thru 9-1-05
410-147-0420 Rebasing (1) Determination of encounter rates effective January 1, 2001 as directed by the Balanced Budget Act (BBA) of 1997 and the Budget Refinement Act of 1999 Prospective Payment System (PPS) was changed for Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) clinics. PPS eliminates annual cost reports and retrospective settlements except for managed care organization (MCO) Supplemental Payments. (2) As directed by the BBA and PPS, the federal government will notify states when clinics can re-base clinic rates. No specific date has been determined by the federal government at this time. Statutory/Other Authority: ORS 413.042 & 414.065, 42 USC 1396a(bb) & CFR Title 42 Public Health Statutes/Other Implemented: ORS 414.065 History: OMAP 71-2003, f. 9-15-03, cert. ef. 10-1-03 OMAP 63-2002, f. & cert. ef. 10-1-02
410-147-0440 Medicare Economic Index (MEI) Effective January 1, 2001, as directed by the Balanced Budget Act of 1997, the Budget Refinement Act of 1999 Prospective Payment System (PPS), and BIPA all encounter rates must be adjusted annually by the Medicare Economic Index (MEI) for the current year. The encounter rate will be adjusted by the MEI effective January 1st of the current year. Statutory/Other Authority: 413.042 & 414.065 42 USC 1396a(bb) & CFR Title 42 Public Health Statutes/Other Implemented: ORS 414.065 History: OMAP 63-2002, f. & cert. ef. 10-1-02