Or. Admin. R. 411-415-0120
Reimbursement for Case Management Services
Effective Dec 28, 2018ORS 409.050, 427.104, 427.105, 427.115, 427.154 & 430.662 | Statutes/Other Implemented: ORS 427.007, 427.104, 427.105, 427.115, 427.121, 427.154, 427.160, 430.212, 430.215, 430.610, 430.620, 430.662 & 430.664Department of Human Services
A CME is reimbursed for case management activities. Reimbursement may only be made when:
- (1) The claim for reimbursement is for a service provided to an individual determined eligible for case management services.
- (2) The person providing the service is a qualified case manager as described in OAR 411-415-0040 or an assessor as defined in OAR 411-317-0000.
- (3) An individual is properly enrolled into the Department’s electronic payment and reporting system.
- (4) A claim has been made in the Department’s electronic payment and reporting system.
- (5) Case management has been authorized in an ISP or as part of an Annual Plan.
- (6) The claim is for a qualifying case management service.
- (7) A progress note is in the individual file supporting the delivery of a case management service.
Statutory/Other Authority
ORS 409.050, 427.104, 427.105, 427.115, 427.154 & 430.662
Statutes/Other Implemented
ORS 427.007, 427.104, 427.105, 427.115, 427.121, 427.154, 427.160, 430.212, 430.215, 430.610, 430.620, 430.662 & 430.664
History
APD 46-2018, amend filed 12/28/2018, effective 12/28/2018
APD 23-2018, temporary amend filed 07/02/2018, effective 07/02/2018 through 12/27/2018
APD 28-2016, f. & cert. ef. 6-29-16