When Medicare is the primary payer, services provided in the inpatient or out-patient setting do not require prior authorization. However, if the Division is the primary payer because the service is not covered by Medicare; the prior authorization requirements listed in chapter 410 division 125 would apply.

Statutory/Other Authority

ORS 413.042

Statutes/Other Implemented

ORS 414.065

History

OMAP 70-2004, f. 9-15-04, cert. ef. 10-1-04
HR 42-1991, f. & cert. ef. 10-1-91