1. (1) The Division of Medical Assistance Programs (Division) will not reimburse for the following services/supplies for clients residing in a nursing facility:

   1. (a) Nursing service visits (including assessment visit). Refer to Aging and People with Disabilities (APD) administrative rule covering all-inclusive rate;
   2. (b) Supplies and items covered in the nursing facility All-inclusive rate. Refer to the Supplemental Information section of the Home Enteral/Parenteral Nutrition and IV Services provider website (http://www.oregon.gov/OHA/HSD/OHP/Pages/Policy-Home-EPIV.aspx) for a listing of those supplies and items;
   3. (c) Oral nutritional supplements that are in addition to consumption of food items or meals.

2. (2) The Division will reimburse for the following:

   1. (a) Oral nutritional supplements are covered by the Division for nursing facility clients when medically appropriate, i.e., the client cannot consume food items or meals;
   2. (b) Tube fed enteral nutrition formula, when medically appropriate;

   3. (c) Patient controlled pump for pain control medication (CADD).

      [Publications: Publications referenced are available from the agency.]

Statutory/Other Authority

ORS 413.042

Statutes/Other Implemented

ORS 414.065

History

DMAP 64-2018, minor correction filed 05/25/2018, effective 05/25/2018
OMAP 15-2004, f. 3-11-04, cert. ef. 4-1-04
OMAP 63-2003, f. 9-5-03, cert. ef. 10-1-03
OMAP 46-2001, f. 9-24-01, cert. ef. 10-1-01, Renumbered from 410-121-0730
HR 11-1994, f. 2-25-94, cert. ef. 2-27-94
HR 34-1993(Temp), f. & cert. ef. 12-1-93
HR 26-1993, f. & cert. ef. 10-1-93