1. (1) The Authority may adopt reasonable and lawful policies, procedures, rules and interpretations to promote the orderly and efficient administration of the Oregon Integrated and Coordinated Health Care Delivery System and medical assistance programs. This includes the Oregon Health Plan (OHP) pursuant to ORS Chapter 414, subject to the rulemaking requirements of Oregon Revised Statutes and Oregon Administrative Rule (OAR) procedures.

2. (2) To the extent possible, the Authority’s policies, procedures, rules, and MCE contracts shall be interpreted to avoid a conflict among themselves or with governing state or federal law. In the event of an irreconcilable conflict, the following order of precedence shall govern:

   1. (a) Medicaid Plan and waivers or other directives from CMS;
   2. (b) Federal Statutes;
   3. (c) Federal Regulations;
   4. (d) Oregon Revised Statutes;

   5. (e) Oregon Administrative Rules using the following order of precedence:

      1. (A) This OAR chapter 410 division 141 (“Oregon Health Plan”);
      2. (B) OAR chapter 410 division 120 (“Medical Assistance Programs”);
      3. (C) Any applicable Provider rules in OAR 410 based on the category of health service;
      4. (D) OAR Chapter 943, Division 120;
      5. (E) OAR Chapter 309;
      6. (F) All other applicable OARs;
   6. (f) The MCE Contract, including any internal order of precedence established therein.

Statutory/Other Authority

ORS 413.042, 414.615, 414.625, 414.635 & 414.651

Statutes/Other Implemented

ORS 414.610 - 414.685

History

DMAP 55-2019, adopt filed 12/17/2019, effective 01/01/2020