Or. Admin. R. 410-141-3930 - Transportation: Out-of-Service Area and Out-of-State Transportation

(1) A CCO shall provide NEMT services outside the CCO's service area under any and all of the following circumstances:

(a) The member is receiving covered services that are not available, in accordance with OAR 410-141-3515, in the CCO's service area;

(b) The member is receiving covered services outside of Oregon, but the location is contiguous to the CCO's service area and no more than 75 miles from the Oregon border;

(c) The member is receiving in-patient services at a facility outside the CCO's service area due to unavailability within the CCO's service area and the member requires additional covered services within the service area where the inpatient service facility is located; and

(d) The member is receiving covered services outside the State of Oregon because the required covered service is not available within Oregon.

(2) Nothing in this rule prohibits a CCO from providing and paying for NEMT services to allow a client to access other services the CCO authorizes.

Notes

Or. Admin. R. 410-141-3930

DMAP 57-2019, adopt filed 12/17/2019, effective 1/1/2020

Statutory/Other Authority: ORS 413.042 & ORS 414.625

Statutes/Other Implemented: ORS 414.625