State Codes and Statutes
Statutes > Oregon > Vol10 > 414 Chapter 414 — MedicalAssistance
2009 EDITION
MEDICALASSISTANCE
HUMANSERVICES; JUVENILE CODE; CORRECTIONS
GENERALPROVISIONS
414.018 Goals;findings
414.025 Definitions
414.033 Expendituresfor medical assistance authorized
414.034 Acceptanceof federal billing, reimbursement and reporting forms
414.041 Applicationprocess; outreach and enrollment
MEDICALASSISTANCE
414.065 Determinationof health services covered; standards; cost sharing; payments by Oregon HealthAuthority as payment in full; rules
414.075 Paymentof deductibles imposed under federal law
414.095 Exemptionsapplicable to payments
414.109 OregonHealth Plan Fund
INSURANCEAND SERVICE CONTRACTS
414.115 Medicalassistance by insurance or service contracts; rules
414.125 Rateson insurance or service contracts; requirements for insurer or contractor
414.135 Contractsrelating to direct providers of care and services
414.145 Implementationof ORS 414.115, 414.125 or 414.135
STATEAND LOCAL PUBLIC HEALTH PARTNERSHIP
414.150 Purposeof ORS 414.150 to 414.153
414.152 Dutiesof state agencies
414.153 Authorizationfor payment for certain services
ADVISORYCOMMITTEES
414.211 MedicaidAdvisory Committee
414.221 Dutiesof committee
414.225 OregonHealth Authority to consult with committee
414.227 Applicationof public meetings law to advisory committees
414.229 Officefor Oregon Health Policy and Research Advisory Committee
HEALTHCARE FOR ALL OREGON CHILDREN PROGRAM
414.231 Eligibilityfor Healthy Kids program; 12-month continuous enrollment; verification ofeligibility; uninsurance requirement; rules
PRESCRIPTIONDRUGS
(OregonPrescription Drug Program)
414.312 OregonPrescription Drug Program
414.314 Applicationand participation in Oregon Prescription Drug Program; prescription drugcharges; fees
414.316 Preferreddrug list for Oregon Prescription Drug Program
414.318 PrescriptionDrug Purchasing Fund
414.320 Rules
(PrescriptionDrug Coverage by Medical Assistance)
414.325 Prescriptiondrugs; use of legend or generic drugs; prior authorization; rules
414.327 Electronicallytransmitted prescriptions; rules
414.329 Prescriptiondrug benefits for certain persons who are eligible for Medicare Part Dprescription drug coverage; rules
(Practitioner-ManagedPrescription Drug Plan)
414.330 Legislativefindings on prescription drugs
414.332 Policyfor Practitioner-Managed Prescription Drug Plan
414.334 Practitioner-ManagedPrescription Drug Plan for medical assistance program
414.337 Limitationon rules regarding Practitioner-Managed Prescription Drug Plan
(PatientPrescription Drug Assistance Program)
414.338 PatientPrescription Drug Assistance Program; College of Pharmacy at Oregon StateUniversity to operate program
DRUGUSE REVIEW BOARD
414.350 Definitionsfor ORS 414.350 to 414.415
414.355 DrugUse Review Board created; duties; members; term; qualifications
414.360 Dutiesof Drug Use Review Board regarding retrospective and prospective drug usereview programs; rules
414.365 Educationaland informational duties of Drug Use Review Board; procedures to insureconfidentiality
414.370 Authorizedintervention procedures
414.375 Standardsfor prospective drug use review program
414.380 Standardsfor retrospective drug use review program
414.385 Compliancewith Omnibus Budget Reconciliation Act of 1990
414.390 Unauthorizeddisclosure of information prohibited; staff access to information
414.395 Whenexecutive session authorized; public testimony
414.400 DrugUse Review Board subject to public record laws; chairperson; expenses; quorum;advisory committees
414.410 Staff
414.415 Contentsof annual report; public comment
MEDICALASSISTANCE FOR CERTAIN INDIVIDUALS
414.426 Paymentof cost of medical care for institutionalized persons
414.428 Coveragefor American Indian and Alaskan Native beneficiaries
414.500 Findingsregarding medical assistance for persons with hemophilia
414.510 Definitions
414.520 Hemophiliaservices
414.530 Whenpayments not made for hemophilia services
414.532 Definitionsfor ORS 414.534 to 414.538
414.534 Treatmentfor breast or cervical cancer; eligibility criteria for medical assistance
414.536 Presumptiveeligibility for medical assistance for treatment of breast or cervical cancer
414.538 Prohibitionon coverage limitations; priority to low-income women
414.540 Rules
414.550 Definitionsfor ORS 414.550 to 414.565
414.555 Findingsregarding medical assistance for persons with cystic fibrosis
414.560 Cysticfibrosis services
414.565 Whenpayments not made for cystic fibrosis services
OREGONHEALTH CARE COST CONTAINMENT SYSTEM
414.610 Legislativeintent
414.620 Systemestablished
414.630 Prepaidcapitated health care service contracts; when fee for services to be paid
414.640 Selectionof providers; reimbursement for services not covered; actions as tradepractice; actions not insurance; rules
SCOPEOF COVERED HEALTH SERVICES
414.705 Definitionsfor ORS 414.705 to 414.750
414.706 Legislativeapproval and funding of health services to certain persons
414.707 Levelof health services provided to certain persons
414.708 Conditionsfor coverage for certain elderly persons, blind persons or persons who havedisabilities
414.709 Adjustmentof population of eligible persons in event of insufficient resources
414.710 Servicesnot subject to prioritized list
414.712 Medicalassistance for certain eligible persons
414.715 HealthServices Commission; confirmation; qualifications; terms; expenses;subcommittees
414.720 Publichearings; public involvement; biennial reports on health services priorities;funding
414.721 Federalapproval for funding services with assessments
414.725 Prepaidmanaged care health services contracts; financial reporting; rules
414.727 Reimbursementof rural hospitals by prepaid managed care health services organization
414.728 Reimbursementof rural hospitals by Oregon Health Authority
414.730 Subcommitteeon Mental Health Care and Chemical Dependency
414.735 Adjustmentof reimbursement in event of insufficient resources; approval of LegislativeAssembly or Emergency Board; notice to providers
414.736 Definitions
State Codes and Statutes
Statutes > Oregon > Vol10 > 414 Chapter 414 — MedicalAssistance
2009 EDITION
MEDICALASSISTANCE
HUMANSERVICES; JUVENILE CODE; CORRECTIONS
GENERALPROVISIONS
414.018 Goals;findings
414.025 Definitions
414.033 Expendituresfor medical assistance authorized
414.034 Acceptanceof federal billing, reimbursement and reporting forms
414.041 Applicationprocess; outreach and enrollment
MEDICALASSISTANCE
414.065 Determinationof health services covered; standards; cost sharing; payments by Oregon HealthAuthority as payment in full; rules
414.075 Paymentof deductibles imposed under federal law
414.095 Exemptionsapplicable to payments
414.109 OregonHealth Plan Fund
INSURANCEAND SERVICE CONTRACTS
414.115 Medicalassistance by insurance or service contracts; rules
414.125 Rateson insurance or service contracts; requirements for insurer or contractor
414.135 Contractsrelating to direct providers of care and services
414.145 Implementationof ORS 414.115, 414.125 or 414.135
STATEAND LOCAL PUBLIC HEALTH PARTNERSHIP
414.150 Purposeof ORS 414.150 to 414.153
414.152 Dutiesof state agencies
414.153 Authorizationfor payment for certain services
ADVISORYCOMMITTEES
414.211 MedicaidAdvisory Committee
414.221 Dutiesof committee
414.225 OregonHealth Authority to consult with committee
414.227 Applicationof public meetings law to advisory committees
414.229 Officefor Oregon Health Policy and Research Advisory Committee
HEALTHCARE FOR ALL OREGON CHILDREN PROGRAM
414.231 Eligibilityfor Healthy Kids program; 12-month continuous enrollment; verification ofeligibility; uninsurance requirement; rules
PRESCRIPTIONDRUGS
(OregonPrescription Drug Program)
414.312 OregonPrescription Drug Program
414.314 Applicationand participation in Oregon Prescription Drug Program; prescription drugcharges; fees
414.316 Preferreddrug list for Oregon Prescription Drug Program
414.318 PrescriptionDrug Purchasing Fund
414.320 Rules
(PrescriptionDrug Coverage by Medical Assistance)
414.325 Prescriptiondrugs; use of legend or generic drugs; prior authorization; rules
414.327 Electronicallytransmitted prescriptions; rules
414.329 Prescriptiondrug benefits for certain persons who are eligible for Medicare Part Dprescription drug coverage; rules
(Practitioner-ManagedPrescription Drug Plan)
414.330 Legislativefindings on prescription drugs
414.332 Policyfor Practitioner-Managed Prescription Drug Plan
414.334 Practitioner-ManagedPrescription Drug Plan for medical assistance program
414.337 Limitationon rules regarding Practitioner-Managed Prescription Drug Plan
(PatientPrescription Drug Assistance Program)
414.338 PatientPrescription Drug Assistance Program; College of Pharmacy at Oregon StateUniversity to operate program
DRUGUSE REVIEW BOARD
414.350 Definitionsfor ORS 414.350 to 414.415
414.355 DrugUse Review Board created; duties; members; term; qualifications
414.360 Dutiesof Drug Use Review Board regarding retrospective and prospective drug usereview programs; rules
414.365 Educationaland informational duties of Drug Use Review Board; procedures to insureconfidentiality
414.370 Authorizedintervention procedures
414.375 Standardsfor prospective drug use review program
414.380 Standardsfor retrospective drug use review program
414.385 Compliancewith Omnibus Budget Reconciliation Act of 1990
414.390 Unauthorizeddisclosure of information prohibited; staff access to information
414.395 Whenexecutive session authorized; public testimony
414.400 DrugUse Review Board subject to public record laws; chairperson; expenses; quorum;advisory committees
414.410 Staff
414.415 Contentsof annual report; public comment
MEDICALASSISTANCE FOR CERTAIN INDIVIDUALS
414.426 Paymentof cost of medical care for institutionalized persons
414.428 Coveragefor American Indian and Alaskan Native beneficiaries
414.500 Findingsregarding medical assistance for persons with hemophilia
414.510 Definitions
414.520 Hemophiliaservices
414.530 Whenpayments not made for hemophilia services
414.532 Definitionsfor ORS 414.534 to 414.538
414.534 Treatmentfor breast or cervical cancer; eligibility criteria for medical assistance
414.536 Presumptiveeligibility for medical assistance for treatment of breast or cervical cancer
414.538 Prohibitionon coverage limitations; priority to low-income women
414.540 Rules
414.550 Definitionsfor ORS 414.550 to 414.565
414.555 Findingsregarding medical assistance for persons with cystic fibrosis
414.560 Cysticfibrosis services
414.565 Whenpayments not made for cystic fibrosis services
OREGONHEALTH CARE COST CONTAINMENT SYSTEM
414.610 Legislativeintent
414.620 Systemestablished
414.630 Prepaidcapitated health care service contracts; when fee for services to be paid
414.640 Selectionof providers; reimbursement for services not covered; actions as tradepractice; actions not insurance; rules
SCOPEOF COVERED HEALTH SERVICES
414.705 Definitionsfor ORS 414.705 to 414.750
414.706 Legislativeapproval and funding of health services to certain persons
414.707 Levelof health services provided to certain persons
414.708 Conditionsfor coverage for certain elderly persons, blind persons or persons who havedisabilities
414.709 Adjustmentof population of eligible persons in event of insufficient resources
414.710 Servicesnot subject to prioritized list
414.712 Medicalassistance for certain eligible persons
414.715 HealthServices Commission; confirmation; qualifications; terms; expenses;subcommittees
414.720 Publichearings; public involvement; biennial reports on health services priorities;funding
414.721 Federalapproval for funding services with assessments
414.725 Prepaidmanaged care health services contracts; financial reporting; rules
414.727 Reimbursementof rural hospitals by prepaid managed care health services organization
414.728 Reimbursementof rural hospitals by Oregon Health Authority
414.730 Subcommitteeon Mental Health Care and Chemical Dependency
414.735 Adjustmentof reimbursement in event of insufficient resources; approval of LegislativeAssembly or Emergency Board; notice to providers
414.736 Definitions
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State Codes and Statutes
Statutes >
Oregon >
Vol10 >
414 Chapter 414 — MedicalAssistance
2009 EDITION
MEDICALASSISTANCE
HUMANSERVICES; JUVENILE CODE; CORRECTIONS
GENERALPROVISIONS
414.018 Goals;findings
414.025 Definitions
414.033 Expendituresfor medical assistance authorized
414.034 Acceptanceof federal billing, reimbursement and reporting forms
414.041 Applicationprocess; outreach and enrollment
MEDICALASSISTANCE
414.065 Determinationof health services covered; standards; cost sharing; payments by Oregon HealthAuthority as payment in full; rules
414.075 Paymentof deductibles imposed under federal law
414.095 Exemptionsapplicable to payments
414.109 OregonHealth Plan Fund
INSURANCEAND SERVICE CONTRACTS
414.115 Medicalassistance by insurance or service contracts; rules
414.125 Rateson insurance or service contracts; requirements for insurer or contractor
414.135 Contractsrelating to direct providers of care and services
414.145 Implementationof ORS 414.115, 414.125 or 414.135
STATEAND LOCAL PUBLIC HEALTH PARTNERSHIP
414.150 Purposeof ORS 414.150 to 414.153
414.152 Dutiesof state agencies
414.153 Authorizationfor payment for certain services
ADVISORYCOMMITTEES
414.211 MedicaidAdvisory Committee
414.221 Dutiesof committee
414.225 OregonHealth Authority to consult with committee
414.227 Applicationof public meetings law to advisory committees
414.229 Officefor Oregon Health Policy and Research Advisory Committee
HEALTHCARE FOR ALL OREGON CHILDREN PROGRAM
414.231 Eligibilityfor Healthy Kids program; 12-month continuous enrollment; verification ofeligibility; uninsurance requirement; rules
PRESCRIPTIONDRUGS
(OregonPrescription Drug Program)
414.312 OregonPrescription Drug Program
414.314 Applicationand participation in Oregon Prescription Drug Program; prescription drugcharges; fees
414.316 Preferreddrug list for Oregon Prescription Drug Program
414.318 PrescriptionDrug Purchasing Fund
414.320 Rules
(PrescriptionDrug Coverage by Medical Assistance)
414.325 Prescriptiondrugs; use of legend or generic drugs; prior authorization; rules
414.327 Electronicallytransmitted prescriptions; rules
414.329 Prescriptiondrug benefits for certain persons who are eligible for Medicare Part Dprescription drug coverage; rules
(Practitioner-ManagedPrescription Drug Plan)
414.330 Legislativefindings on prescription drugs
414.332 Policyfor Practitioner-Managed Prescription Drug Plan
414.334 Practitioner-ManagedPrescription Drug Plan for medical assistance program
414.337 Limitationon rules regarding Practitioner-Managed Prescription Drug Plan
(PatientPrescription Drug Assistance Program)
414.338 PatientPrescription Drug Assistance Program; College of Pharmacy at Oregon StateUniversity to operate program
DRUGUSE REVIEW BOARD
414.350 Definitionsfor ORS 414.350 to 414.415
414.355 DrugUse Review Board created; duties; members; term; qualifications
414.360 Dutiesof Drug Use Review Board regarding retrospective and prospective drug usereview programs; rules
414.365 Educationaland informational duties of Drug Use Review Board; procedures to insureconfidentiality
414.370 Authorizedintervention procedures
414.375 Standardsfor prospective drug use review program
414.380 Standardsfor retrospective drug use review program
414.385 Compliancewith Omnibus Budget Reconciliation Act of 1990
414.390 Unauthorizeddisclosure of information prohibited; staff access to information
414.395 Whenexecutive session authorized; public testimony
414.400 DrugUse Review Board subject to public record laws; chairperson; expenses; quorum;advisory committees
414.410 Staff
414.415 Contentsof annual report; public comment
MEDICALASSISTANCE FOR CERTAIN INDIVIDUALS
414.426 Paymentof cost of medical care for institutionalized persons
414.428 Coveragefor American Indian and Alaskan Native beneficiaries
414.500 Findingsregarding medical assistance for persons with hemophilia
414.510 Definitions
414.520 Hemophiliaservices
414.530 Whenpayments not made for hemophilia services
414.532 Definitionsfor ORS 414.534 to 414.538
414.534 Treatmentfor breast or cervical cancer; eligibility criteria for medical assistance
414.536 Presumptiveeligibility for medical assistance for treatment of breast or cervical cancer
414.538 Prohibitionon coverage limitations; priority to low-income women
414.540 Rules
414.550 Definitionsfor ORS 414.550 to 414.565
414.555 Findingsregarding medical assistance for persons with cystic fibrosis
414.560 Cysticfibrosis services
414.565 Whenpayments not made for cystic fibrosis services
OREGONHEALTH CARE COST CONTAINMENT SYSTEM
414.610 Legislativeintent
414.620 Systemestablished
414.630 Prepaidcapitated health care service contracts; when fee for services to be paid
414.640 Selectionof providers; reimbursement for services not covered; actions as tradepractice; actions not insurance; rules
SCOPEOF COVERED HEALTH SERVICES
414.705 Definitionsfor ORS 414.705 to 414.750
414.706 Legislativeapproval and funding of health services to certain persons
414.707 Levelof health services provided to certain persons
414.708 Conditionsfor coverage for certain elderly persons, blind persons or persons who havedisabilities
414.709 Adjustmentof population of eligible persons in event of insufficient resources
414.710 Servicesnot subject to prioritized list
414.712 Medicalassistance for certain eligible persons
414.715 HealthServices Commission; confirmation; qualifications; terms; expenses;subcommittees
414.720 Publichearings; public involvement; biennial reports on health services priorities;funding
414.721 Federalapproval for funding services with assessments
414.725 Prepaidmanaged care health services contracts; financial reporting; rules
414.727 Reimbursementof rural hospitals by prepaid managed care health services organization
414.728 Reimbursementof rural hospitals by Oregon Health Authority
414.730 Subcommitteeon Mental Health Care and Chemical Dependency
414.735 Adjustmentof reimbursement in event of insufficient resources; approval of LegislativeAssembly or Emergency Board; notice to providers
414.736 Definitions
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