Targeted Case Management (TCM) services do not cover:

1. (1) Direct delivery of an underlying medical, educational, social, or other service to which the eligible client has been referred.
2. (2) Providing transportation to a service to which an eligible client is referred.
3. (3) Escorting an eligible client to a service.
4. (4) Providing child care so that an eligible client may access a service.
5. (5) Contacts with individuals who are not categorically eligible for Medicaid or who are categorically eligible for Medicaid but not included in the eligible target population when those contacts relate directly to the identification and management of the non-eligible or non-targeted individual’s needs and care.
6. (6) Assisting an individual who has not yet been determined eligible for Medicaid to apply for or obtain eligibility.
7. (7) TCM services provided to an individual if the services are case management services funded by Title IV-E or Title XX of the Social Security Act, or federal or state funded parole and probation, or juvenile justice programs.
8. (8) Activities for which third parties are liable to pay.

Statutory/Other Authority

ORS 413.042 & 414.065

Statutes/Other Implemented

ORS 414.065

History

DMAP 9-2017, f. 3-31-17, cert. ef. 4-1-17
DMAP 4-2017(Temp), f. 2-2-17, cert. ef. 2-10-17 thru 7-11-17
DMAP 2-2017(Temp), f. & cert. ef. 1-13-17 thru 7-11-17
DMAP 76-2016, f. 12-29-16, cert. ef. 1-1-17
DMAP 23-2014, f. & cert. ef. 4-4-14
DMAP 75-2013(Temp), f. 12-31-13, cert. ef. 1-1-14 thru 6-30-14
DMAP 41-2010, f. 12-28-10, cert. ef. 1-1-11
DMAP 22-2010, f. 6-30-10, cert. ef. 7-1-10
DMAP 43-2009, f. 12-15-09, cert. ef. 1-1-10
DMAP 43-2008, f. 12-17-08, cert. ef. 12-28-08
DMAP 32-2008(Temp), f. & cert. ef. 10-2-08 thru 3-27-09