OAR 410-133-0180
Duplication of Service

(1)

The School Medical (SM) provider that utilizes a contractor to provide health services may only bill The Oregon Health Authority (Authority) or the Division of Medical Assistance Programs (Division) for health services when the school medical (SM) provider and the contracted provider have previously agreed that the contractor will not also bill for the same service.

(2)

Duplicate billings are not allowed and payments will be recovered. Billings for health services to Medicaid-eligible students will be considered as duplicate if the same services are billed by more than one Educational Agency (EA) to address the same need. For example: an Education Service District (ESD) and a local school district cannot both bill the same services provided to the student.

(3)

A unit of service can only be billed once; under one procedure code, under one provider number.

Source: Rule 410-133-0180 — Duplication of Service, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-133-0180.

Last Updated

Jun. 8, 2021

Rule 410-133-0180’s source at or​.us