OAR 410-148-0120
Reimbursement Limitations for Clients in a Nursing Facility

(1)

The Division of Medical Assistance Programs (Division) will not reimburse for the following services/supplies for clients residing in a nursing facility:

(a)

Nursing service visits (including assessment visit). Refer to Aging and People with Disabilities (APD) administrative rule covering all-inclusive rate;

(b)

Supplies and items covered in the nursing facility All-inclusive rate. Refer to the Supplemental Information section of the Home Enteral/Parenteral Nutrition and IV Services provider website (http:/­/­www.oregon.gov/­OHA/­HSD/­OHP/­Pages/­Policy-Home-EPIV.aspx) for a listing of those supplies and items;

(c)

Oral nutritional supplements that are in addition to consumption of food items or meals.

(2)

The Division will reimburse for the following:

(a)

Oral nutritional supplements are covered by the Division for nursing facility clients when medically appropriate, i.e., the client cannot consume food items or meals;

(b)

Tube fed enteral nutrition formula, when medically appropriate;

(c)

Patient controlled pump for pain control medication (CADD).
[Publications: Publications referenced are available from the agency.]

Source: Rule 410-148-0120 — Reimbursement Limitations for Clients in a Nursing Facility, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-148-0120.

Last Updated

Jun. 8, 2021

Rule 410-148-0120’s source at or​.us