Or. Admin. Code § 411-070-0140 - Hospice Services

(1) CONTRACT.

(a) The Department enters into a contract (provider agreement) to reimburse Medicare certified hospice providers in Oregon for services provided in Medicaid certified nursing facilities under the following conditions:

(A) The Medicare-certified hospice provider must have a written contract with the nursing facility; and

(B) A copy of the completed contract must be made available to the Department upon request.

(b) The hospice provider must have a completed, written contract (provider agreement) with the Department for nursing facility-based hospice services prior to being determined eligible for reimbursement.

(2) REIMBURSEMENT.

(a) The Department pays the hospice provider a rate equal to 100 percent of the rate that the nursing facility would otherwise receive.

(b) The hospice provider is solely responsible for reimbursing the nursing facility.

(c) Reimbursement for services provided under this rule is available only if the recipient of such services is Medicaid-eligible, Medicare hospice eligible, and been found to need nursing facility services through the Pre-Admission Screening process.

Notes

Or. Admin. Code § 411-070-0140

SSD 13-1993, f. 12-30-93, cert. ef. 1-1-94; SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06; SPD 9-2013(Temp), f. 4-29-13, cert. ef. 5-1-13 thru 10-28-13; SPD 35-2013, f. & cert. ef. 10-1-13

Stat. Auth.: ORS 410.070 & 414.065

Stats. Implemented: ORS 410.070 & 414.065