Oregon Administrative Rules
Chapter 410 - OREGON HEALTH AUTHORITY, HEALTH SYSTEMS DIVISION: MEDICAL ASSISTANCE PROGRAMS
Division 132 - PRIVATE DUTY NURSING SERVICES
Section 410-132-0100 - Prior Authorization
Universal Citation: OR Admin Rules 410-132-0100
Current through Register Vol. 63, No. 9, September 1, 2024
(1) Private duty nursing providers shall obtain prior authorization (PA) for all services.
(2) Providers shall request PA as follows (see the Private Duty Nursing Services Supplemental Information booklet for contact information):
(a) For individuals served by the MFC), from
the Departments MFC Program;
(b)
For clients enrolled in the fee-for-service (FFS) Medical Case Management (MCM)
program, from the MCM contractor;
(c) For members enrolled in a coordinated
care organization (CCO) or prepaid health plan (PHP), from the CCO or the PHP;
(d) For all other clients, from
the Division.
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 414.065
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