1. (1) An individual receiving HSD Medical Program benefits may not receive the following medical benefits at the same time except as described in section (3) of this rule:

   1. (a) Any other HSD Medical Program;
   2. (b) Office of Child Welfare Medical;
   3. (c) Oregon Youth Authority Medical;
   4. (d) Oregon Supplemental Income Program-Medical (OSIPM); or
   5. (e) Refugee Medical Assistance (REFM).
2. (2) An individual may not receive HSD Medical Program benefits and medical benefits from another state unless the individual’s provider refuses to submit a bill to the Medicaid/CHIP agency of the other state and the individual would not otherwise receive medical care.
3. (3) Individuals may receive the supplemental YSHCN program benefits as described in OAR 410-200-0455(2)(a) and (b) concurrent with the MAGI Medicaid/CHIP programs defined in OAR 410-200-0015(d) and 410-200-0015(f)(A)-(E), and OSIPM programs as defined in OAR 461-101-0010(18).

Statutory/Other Authority

ORS 411.402, 411.404, 413.042 & 414.534

Statutes/Other Implemented

ORS 411.400, 411.402, 411.404, 411.406, 411.439, 411.443, 413.032, 413.038, 414.025, 414.231, 414.447, 414.534, 414.536 & 414.706

History

DMAP 138-2024, amend filed 11/26/2024, effective 01/01/2025
DMAP 23-2020, amend filed 05/07/2020, effective 05/08/2020
DMAP 3-2015, f. & cert. ef. 1-30-15
DMAP 67-2014(Temp), f. 11-14-14, cert. ef. 11-15-14 thru 5-13-15
DMAP 20-2014, f. & cert. ef. 3-28-14
DMAP 4-2014(Temp), f. & cert. ef. 1-15-14 thru 3-30-14
DMAP 54-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14