Or. Admin. R. 411-415-0120 - Reimbursement for Case Management Services

A CME is reimbursed for case management activities. Reimbursement may only be made when:

(1) The claim for reimbursement is for a service provided to an individual determined eligible for case management services.

(2) The person providing the service is a qualified case manager as described in OAR 411-415-0040 or an assessor as defined in OAR 411-317-0000.

(3) An individual is properly enrolled into the Department's electronic payment and reporting system.

(4) A claim has been made in the Department's electronic payment and reporting system.

(5) Case management has been authorized in an ISP or as part of an Annual Plan.

(6) The claim is for a qualifying case management service.

(7) A progress note is in the individual file supporting the delivery of a case management service.

Notes

Or. Admin. R. 411-415-0120

APD 28-2016, f. & cert. ef. 6/29/2016; APD 23-2018, temporary amend filed 07/02/2018, effective 07/02/2018 through 12/27/2018; APD 46-2018, amend filed 12/28/2018, effective 12/28/2018

Statutory/Other Authority: ORS 409.050, 427.104, 427.105, 427.115, 427.154 & 430.662

Statutes/Other Implemented: ORS 427.007, 427.104, 427.105, 427.115, 427.121, 427.154, 427.160, 430.212, 430.215, 430.610, 430.620, 430.662& 430.664