1. (1) Brokerages shall arrange and pay for transporting an eligible client who has had a change in condition, noted in the client’s Oregon Department of Human Services (ODHS) care plan, resulting in a need for a new service setting with a lower or higher level of care. This includes clients who are changing levels of care between their community-based care settings or between institutional and community-based settings. The client’s ODHS worker must request the ride.

2. (2) Brokerages shall not arrange or pay for:

   1. (a) The transport or return of an inpatient client from an admitting hospital to another hospital (or facility) for diagnostic or other short-term services when the patient will return to the admitting hospital within the first 24-hours of admission. The subcontractor shall bill the admitting hospital directly for these transports;
   2. (b) The transport of a client receiving long-term care service in their home or residing in a long-term care facility for the sole purpose of shopping for another long-term care facility, even if the client is looking for a new facility to receive a lower or higher level of care;
   3. (c) The transport of a client moving from one type of facility to a facility of the same type, such as from an adult foster home to another adult foster home; and
   4. (d) The transport of a client who is relocating to another state, unless the transport is to receive an OHP covered medical service pursuant to OAR 410-136-3080, Out-of-State Transportation.

Statutory/Other Authority

ORS 413.042

Statutes/Other Implemented

ORS 414.065

History

DMAP 95-2023, amend filed 12/22/2023, effective 01/01/2024
DMAP 29-2014, f. & cert. ef. 5-20-14
DMAP 69-2013(Temp), f. 12-24-13, cert. ef. 1-1-14 thru 6-30-14
DMAP 36-2013, f. 6-27-13, cert. ef. 7-1-13