Current through Register Vol. 60, No. 12, December 1, 2021
The Division of Medical Assistance
Programs (Division) contracts with Managed Care Organizations (MCO) and Primary
Care Managers (PCM) to provide medical services for clients under the Division
(Title XIX and Title XXI services):
for dental services are called Dental Care Organizations (DCO). See General
Rules OAR 410-120-0250 -- Managed Care Organizations for definitions and
responsibilities of MCOs;
General Rules OAR 410-120-1210(4) -- Medical Assistance Programs and Delivery
Systems for a description of how clients receive services through MCOs and
(2) The Division
prepays DCOs to cover dental services, including the professional component of
any services provided in an Ambulatory Surgical Center (ASC) or an outpatient
or inpatient hospital setting for hospital dentistry. See OAR 410-123-1490 for
more information about hospital dentistry.
(3) The Division will not pay for services
covered by a MCO; reimbursement is a matter between the MCO and the
(4) For clients enrolled
in a DCO, it is the responsibility of the dental provider to coordinate all
dental services with the client's DCO prior to providing services.
Or. Admin. R.
OMAP 23-1999, f. &
cert. ef. 4-30-99; OMAP 17-2000, f. 9-28-00, cert. ef. 10-1-00; OMAP 48-2002,
f. & cert. ef. 10-1-02; DMAP 16-2009 f. 6-12-09, cert. ef.
Stat. Auth.: ORS
Stats. Implemented: ORS