Or. Admin. R. 410-124-0040 - Emergency Transplants

Current through Register Vol. 60, No. 12, December 1, 2021

(1) An Emergency Transplant is one in which medical appropriateness requires that a covered transplant be performed less than five days after determination of the need for a transplant.
(2) Emergency transplants are subject to post transplant review of the client's medical records by the Division of Medical Assistance Programs (Division), or the Fully Capitated Health Plan (FCHP), to determine if the client and the transplant center met the criteria in these rules at the time of the transplant. Related charges, including transportation, physician's services, and donor charges will be covered if payment is approved. The Division will make payment as described in OAR 410-124-0000(9) for Division-covered transplants. FCHPs will make payment as described in their contract.
(3) Transplants are not covered by Citizen/Alien-Waived Emergency Medical (CAWEM) clients, even when emergent.

Notes

Or. Admin. R. 410-124-0040
HR 8-1990(Temp), f. 3-30-90, cert. ef. 4-1-90; HR 22-1990, f. & cert. ef. 7-17-90; HR 4-1994, f. & cert. ef. 2-1-94; OMAP 18-2000 f. 9-28-00, cert. ef. 10-1-00; OMAP 1-2003, f. 1-31-03, cert. ef. 2-1-03

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 414.065

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