Oregon Administrative Rules
Chapter 411 - DEPARTMENT OF HUMAN SERVICES, AGING AND PEOPLE WITH DISABILITIES AND DEVELOPMENTAL DISABILITIES
Division 34 - STATE PLAN PERSONAL CARE SERVICES
Section 411-034-0090 - Payment Limitations

(1) The maximum allowed hours for State Plan personal care services are limited to 270 hours per calendar year for individuals served by APD or a AAA.

(2) Authorized LTC community nurse assessment and monitoring services are not included in the maximum hours per service period for State Plan personal care services described in section (1) of this rule.

(3) The Department does not guarantee payment for State Plan personal care services until all acceptable provider enrollment standards have been verified and both the employer and provider have been formally notified in writing that payment by the Department is authorized.

(4) In accordance with OAR 410-120-1300, all provider claims for payment must be submitted within 12 months of the date of service.

(5) Payment may not be claimed by a provider until the hours authorized for the payment period have been completed, as directed by an eligible individual or the individual's representative.

(6) Claims for Money Management may only be made by qualified money management service providers and are not included in the 270-hour limitation.

(7) Claims for Home Delivered Meals may only be made by qualified HDM providers and are not included in the 270-hour limitation.

(8) Nursing Services may only be made by licensed and enrolled long term care community nurses and the hours authorized for this service are not included in the 270 hour limitation.