- (1) Non-contiguous out-of-state hospitals are those hospitals located more than 75 miles from the Oregon border.
- (2) The hospital must be enrolled as a provider with Oregon Medical Assistance Programs to receive payment. Contact the Division of Medical Assistance Programs (Division) for information on enrollment.
- (3) Billings are sent to the Division.
- (4) When the service provided is emergent or urgent, no prior authorization is required. The claim should be sent to the Division along with documentation supporting the emergent or urgent requirement for treatment.
- (5) In a non-emergency situation, prior authorization is required for all services. Contact: the Division.
- (6) Claims must be billed on the electronic 837I or on a paper CMS 1450 (UB-04), unless other arrangements are made for billing through the Division.
Statutory/Other Authority
ORS 413.042
Statutes/Other Implemented
ORS 414.065
History
DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08
DMAP 19-2008, f. 6-13-08, cert. ef. 7-1-08
OMAP 17-2006, f. 6-12-06, cert. ef. 7-1-06
HR 36-1993, f. & cert. ef. 12-1-93
HR 42-1991, f. & cert. ef. 10-1-91
HR 2-1991, f. & cert. ef. 1-4-91
HR 31-1990(Temp), f. & cert. ef. 9-11-90
HR 21-1990, f. & cert. ef. 7-9-90, Renumbered from 461-015-0450
AFS 72-1989, f. & cert. ef. 12-1-89
AFS 49-1989(Temp), f. 8-24-89, cert. ef. 9-1-89