Current through Register Vol. 60, No. 12, December 1, 2021
A CCO shall
provide NEMT services outside the CCO's service area under any and all of the
(a) The member is
receiving covered services that are not available, in accordance with OAR
410-141-3515, in the CCO's service area;
(b) The member is receiving covered services
outside of Oregon, but the location is contiguous to the CCO's service area and
no more than 75 miles from the Oregon border;
(c) The member is receiving in-patient
services at a facility outside the CCO's service area due to unavailability
within the CCO's service area and the member requires additional covered
services within the service area where the inpatient service facility is
(d) The member is
receiving covered services outside the State of Oregon because the required
covered service is not available within Oregon.
(2) Nothing in this rule prohibits a CCO from
providing and paying for NEMT services to allow a client to access other
services the CCO authorizes.
Or. Admin. R.
57-2019, adopt filed 12/17/2019, effective
Statutory/Other Authority: ORS
413.042 & ORS
Statutes/Other Implemented: ORS