Or. Admin. Code § 410-173-0045 - Documentation Standards

(1) Provider rendering HCBS are required to maintain records that fully support the extent of services for which payment is requested and provide the records to the Division or IQA upon request;

(2) All records shall comply with documentation standards found in OAR 410-120-1360 and 410-172-0620 in addition to the following:

(a) The name of the Individual receiving 1915(i) HCBS services;

(b) The Medicaid Identification Number of the Individual receiving 1915(i) HCBS services;

(c) The name of the provider offering 1915(i) HCBS services;

(d) Type of service being provided as described in the PCSP including:

(e) Date of service;

(f) Start time of each service; and

(g) End time of each service.

(3) Providers shall document services and supports provided to the individual and how the services and supports relate to identified goals and objectives outlined in the PCSP;

(4) Providers shall document the services and supports addressing the following HCBS qualities:

(a) Employment and volunteer opportunities;

(b) Individual choice of community activities and community access;

(c) Access to and control of personal resources; and

(d) Strategies identified in the PCSP to ensure the health and safety of the individual or others.

(5) All Medicaid 1915(i) services provided in a person's own, or family home must be captured using an Electronic Visit Verification (EVV) system to meet requirements in the 21st Century Cures Act. EVV systems shall electronically capture the following information at the time the service is occurring:

(a) Type of service performed;

(b) Individual receiving the service;

(c) Date and location of the service;

(d) Individual providing the service; and

(e) Time the service begins and ends.

(6) Information contained in the record shall be appropriate in quality and quantity to meet the professional standards applicable to the provider and any additional standards for documentation found in these rules, other Division rules, and pertinent contracts.

Notes

Or. Admin. Code § 410-173-0045

DMAP 12-2019, temporary adopt filed 05/21/2019, effective 06/01/2019 through 11/27/2019; DMAP 46-2019, adopt filed 11/07/2019, effective 11/26/2019; DMAP 42-2024, amend filed 02/14/2024, effective 2/29/2024

Statutory/Other Authority: ORS 124.050 - 124.095, 163.275 & 443.765

Statutes/Other Implemented: ORS 124.050 - 124.095, 163.275 & 443.765