OAR 410-120-0011
Effect of COVID-19 Emergency Authorities on Administrative Rules

(1) Under authority of the President’s declaration of a national emergency related to COVID-19:
(a) On March 25, 2020 the Centers for Medicare and Medicaid Services (CMS) approved temporary modifications and waivers requested by the Authority under Section 1135 of the Social Security Act to certain Medicaid, CHIP, and HIPAA requirements (March 25 State Specific Waiver, posted at https://govstatus.egov.com/OR-OHA-COVID-19).
(b) On March 13, 2020, CMS issued a blanket 1135 waiver, applicable to all fifty of the United States, of certain requirements set forth in Titles XVIII, XIX, and XXI of the Social Security Act (March 13 Blanket Waiver, described at https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf).
(c) On March 26, 2020, CMS issued a letter to the Oregon Association of Hospitals and Health Systems, waiving certain federal requirements applicable to hospitals and other providers (March 26 Provider Waiver, posted at https://static1.squarespace.com/static/5e712c5039792019ff647a40/t/5e7ed359d5037c1157b16618/1585369947488/OR-Oregon+Waiver+Approval+3-26-2020.pdf).
(d) On or before March 30, 2020, CMS issued a number of COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (CMS Blanket Provider Waivers, posted at https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers).
(2) In this rule, “COVID-19 Emergency Authorities” means the March 25 State Specific Waiver, the March 13 Blanket Waiver, the March 26 Provider Waiver, the CMS Blanket Provider Waivers, and all emergency orders or declarations relating to COVID-19 by the Governor of the State of Oregon (posted at https:/­/­www.oregon.gov/­gov/­admin/­Pages/­executive-orders.aspx) or by the Authority (posted at https://govstatus.egov.com/OR-OHA-COVID-19, tab on “OHA Guidance and Emergency Rules”). In the event of termination or withdrawal of any of the COVID-19 Emergency Authorities in effect on the date this rule is adopted, the term “COVID-19 Emergency Authorities” means only those waivers, emergency orders or declarations described in the previous sentence that remain in effect.
(3) The purpose of this rule is to ensure medical assistance programs provide all appropriate and necessary services, providers are able to operate and deliver services effectively and efficiently, and the medical assistance programs are administered effectively and efficiently, all in accordance with the COVID-19 Emergency Authorities with the goal of reducing adverse impacts from COVID-19.
(4) In order to accomplish the purposes identified above, and consistent with the COVID-19 Emergency Authorities, all rules in this chapter inconsistent with the COVID-19 Emergency Authorities are hereby suspended. OHA shall issue guidance concerning any rule in this chapter 410 that is inconsistent with the COVID-19 Emergency Authorities and is deemed to be suspended pursuant to this paragraph.
(5) In addition to issuing the guidance described in section (4) of this rule, the Authority may do any of, or any combination of, the following:
(a) Issue guidance on how an existing rule in this chapter is to be interpreted and applied;
(b) Suspend one or more existing rules in this chapter, in accordance with normal administrative procedures or by the Governor’s rule suspension authority; or
(c) Adopt one or more temporary rules in this chapter, in accordance with normal administrative procedures.
(6) OHA shall post any guidance issued under this rule at https://govstatus.egov.com/OR-OHA-COVID-19, tab on “OHA Guidance and Emergency Rules.”

Source: Rule 410-120-0011 — Effect of COVID-19 Emergency Authorities on Administrative Rules, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-120-0011.

410‑120‑0000
Acronyms and Definitions 410‑120‑0003
OHP Standard Benefit Package 410‑120‑0006
Medical Eligibility Standards 410‑120‑0011
Effect of COVID-19 Emergency Authorities on Administrative Rules 410‑120‑0025
Administration of Division of Medical Assistance Programs, Regulation and Rule Precedence 410‑120‑0030
Children’s Health Insurance Program 410‑120‑0035
Public Entity 410‑120‑0045
Applications for Medical Assistance at Provider locations 410‑120‑0250
Managed Care Entity 410‑120‑1140
Verification of Eligibility and Coverage 410‑120‑1160
Medical Assistance Benefits and Provider Rules 410‑120‑1180
Medical Assistance Benefits: Out-of-State Services 410‑120‑1190
Medically Needy Benefit Program 410‑120‑1195
SB 5548 Population 410‑120‑1200
Excluded Services and Limitations 410‑120‑1210
Medical Assistance Benefit Packages and Delivery System 410‑120‑1260
Provider Enrollment 410‑120‑1280
Billing 410‑120‑1285
Recoupment and Data Sharing with Third-Party Insurers 410‑120‑1295
Non-Participating Provider 410‑120‑1300
Timely Submission of Claims 410‑120‑1320
Authorization of Payment 410‑120‑1340
Payment 410‑120‑1350
Buying-Up 410‑120‑1360
Requirements for Financial, Clinical and Other Records 410‑120‑1380
Compliance with Federal and State Statutes 410‑120‑1385
Compliance with Public Meetings Law 410‑120‑1390
Premium Sponsorships 410‑120‑1395
Program Integrity 410‑120‑1396
Provider and Contractor Audits 410‑120‑1397
Recovery of Overpayments to Providers — Recoupments and Refunds 410‑120‑1400
Provider Sanctions 410‑120‑1460
Type and Conditions of Sanction 410‑120‑1510
Fraud and Abuse 410‑120‑1560
Provider Appeals 410‑120‑1570
Claim Re-Determinations 410‑120‑1580
Provider Appeals — Administrative Review 410‑120‑1600
Provider Appeals — Contested Case Hearings 410‑120‑1855
Client’s Rights and Responsibilities 410‑120‑1860
Contested Case Hearing Procedures 410‑120‑1865
Denial, Reduction, or Termination of Services 410‑120‑1870
Client Premium Payments 410‑120‑1875
Agency Hearing Representatives 410‑120‑1880
Contracted Services 410‑120‑1920
Institutional Reimbursement Changes 410‑120‑1940
Interest Payments on Overdue Claims 410‑120‑1960
Payment of Private Insurance Premiums 410‑120‑1980
Requests for Information and Public Records 410‑120‑1990
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Last Updated

Jun. 8, 2021

Rule 410-120-0011’s source at or​.us