Medicaid Long-Term Care Quality and Reimbursement Advisory Council - Council Operation
(1)Within 60 calendar days after receipt from the Department or Authority of any proposed change or modification to the Medicaid reimbursement system, the Council shall issue a written advisory recommendation to the Department or Authority. The 60-day period begins the day following delivery to the chairperson of the Council if a proposed change or modification is faxed, hand-delivered, or e-mailed. Otherwise, the 60-day period begins the third day after the date of mailing first class.
(2)A written advisory recommendation issued by the Council must state:
(a)Whether the Council supports or opposes the proposed change or modification;
(b)Whether the Council concludes that the proposed change or modification shall have an adverse or positive effect on the quality of long term care and community-based services provided under the Oregon Medicaid program; and
(c)The basis for the Council’s recommendation, which must include:
(A)The reason for the Council’s position;
(B)A list of the principal documents, reports, or studies, if any, relied upon in considering the proposed change or modification; and
(C)Other information deemed appropriate by the Council.
(3)Timeline for written recommendation.
(a)Notwithstanding section (1) of this rule, the Department or Authority may shorten the time within which the Council must issue a written recommendation if the Department or Authority decides to adopt a proposed change or modification by temporary rule and if the Department or Authority prepares a written statement in which the Department or Authority:
(A)Finds that failure to make proposed changes or modifications promptly is likely to result in serious prejudice to the public interest or to the interests of individuals receiving Department or Authority services, providers of long term care or community-based services, or other affected parties;
(B)Specifies reasons why the Department or Authority’s failure to act promptly is likely to result in serious prejudice to those interests;
(C)States the need for the proposed change or modification and how the change or modification is intended to meet the need;
(D)Lists the principal documents, reports, or studies, if any, prepared or relied upon by the Department or Authority in evaluating the need for the proposed change or modification; and
(E)Cites the legal authority relied upon and bearing upon the adoption, amendment, or suspension of the rule if the proposed change or modification is to be made by administrative rule.
(b)However, the Department or Authority may not shorten the time for written recommendation to less than five business days.
(4)If the Department or Authority intends to adopt an administrative rule that directly or indirectly proposes a change or modification to the Medicaid reimbursement system, the Department or Authority may not proceed with notice requirements provided for in ORS 183.335 (Notice) until the Department or Authority has received the Council’s written recommendation as described in section (2) or (3) of this rule.
Rule 411-001-0120 — Medicaid Long-Term Care Quality and Reimbursement Advisory Council - Council Operation,