Or. Admin. R. 410-125-0102 - Medically Needy Clients
Current through Register Vol. 60, No. 12, December 1, 2021
(1)
The QIO can give prior authorization for non-emergency inpatient services for
clients who are in the Medically Needy Program but have not yet met their
spend-down. Only Medically Needy Program clients under age 21 and pregnant
women have coverage for inpatient services if enrolled in the Medically Needy
Program.
(2) Prior authorization
cannot be granted for outpatient services, which require prior authorization.
However, you may contact the Division of Medical Assistance Programs (Division)
Medical/ Dental Group once the client has been made eligible and request
retroactive authorization.
Notes
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 414.065
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