OAR 410-172-0820
Provider Termination

(1)

The Authority may deny or terminate a personal care attendant’s provider enrollment and provider number as described in OAR 411-031-0050 (Termination, Administrative Review, and Hearing Rights). The termination, administrative review, and hearings rights for homecare workers are set forth in OAR 411-031-0050 (Termination, Administrative Review, and Hearing Rights).

(2)

The Authority may deny or terminate a personal support worker’s provider enrollment and provider number when the personal support worker:

(a)

Has been appointed the legal guardian of an individual;

(b)

Has a background check that results in a closed case pursuant to OAR chapter 943, division 007;

(c)

Lacks the skills, knowledge, or ability to perform or learn to perform the required work;

(d)

Violates the protective service and abuse rules in OAR chapter 411, division 20, OAR chapter 407, division 45, and OAR chapter 943, division 45;

(e)

Commits fiscal improprieties;

(f)

Fails to provide the authorized services required by an eligible individual;

(g)

Has been repeatedly late in arriving to work or has absences from work not authorized in advance by an individual;

(h)

Has been intoxicated by alcohol or drugs while providing authorized services to an individual or while in the individual’s home;

(i)

Has manufactured or distributed drugs while providing authorized services to an individual or while in the individual’s home; or

(j)

Has been excluded as a provider by the U.S. Department of Health and Human Services, Office of Inspector General from participation in Medicaid, Medicare, or any other federal health care programs.

(3)

A personal support worker may contest the Authority’s decision to terminate the personal support worker’s provider enrollment and provider number:

(a)

A designated employee from the Authority shall review the termination and notify the personal support worker of the decision;

(b)

A personal support worker may file a request for a hearing with the Authority’s local office if all levels of administrative review have been exhausted and the provider continues to dispute the Authority’s decision. The local office shall file the request for a hearing with the Office of Administrative Hearings as described in OAR chapter 137, division 3. The request for a hearing shall be filed within 30 calendar days of the date of the written notice from the Authority;

(c)

When a contested case is referred to the Office of Administrative Hearings, the referral shall indicate whether the Authority is authorizing a proposed order, a proposed and final order, or a final order;

(d)

No additional hearing rights have been granted to a personal support worker by this rule other than the right to a hearing on the Authority’s decision to terminate provider enrollment.

Source: Rule 410-172-0820 — Provider Termination, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-172-0820.

410–172–0600
Acronyms and Definitions 410–172–0610
Provider Enrollment 410–172–0620
Documentation Standards 410–172–0630
Medically Appropriate 410–172–0640
Behavioral Health Services Fee Schedule 410–172–0650
Prior Authorization 410–172–0660
Rehabilitative Behavioral Health Services 410–172–0670
Substance Use Disorder Treatment Services 410–172–0680
Residential Treatment Services for Children 410–172–0690
Admission Procedure for Residential Treatment Services for Children 410–172–0695
Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT) 410–172–0705
Residential Rate Standardization 410–172–0710
Residential Personal Care 410–172–0720
Prior Authorization and Re-Authorization for Residential Treatment 410–172–0730
Payment Limitations for Behavioral Health Services 410–172–0745
Exception Criteria for Facial Gender Confirmation Surgery (FGCS) 410–172–0760
Applied Behavior Analysis 410–172–0770
Individual Eligibility for Applied Behavioral Analysis Treatment 410–172–0780
Behavioral Health Personal Care Attendant Program 410–172–0790
Eligibility for Behavioral Health Personal Care Attendant Services 410–172–0800
Personal Care Attendant Employer-Employee Relationship 410–172–0810
Personal Care Attendant Qualifications 410–172–0820
Provider Termination 410–172–0830
Personal Care Attendant Service Assessment, Authorization, and Monitoring 410–172–0840
Personal Care Attendant Payment Limitations 410–172–0850
Telemedicine for Behavioral Health 410–172–0860
Billing for Dual Eligible Individuals
Last Updated

Jun. 8, 2021

Rule 410-172-0820’s source at or​.us