OAR 411-046-0190
Disenrollment or Termination
(1)
Medicaid providers of Behavior Support Services, their behavior consultant employees, or subcontractors may be terminated or prohibited from providing services for any of the following:(a)
Violation of any part of these rules;(b)
Violation of the protective service and abuse rules in OAR chapter 411, division 20 and chapter 407, division 45;(c)
A demonstrated pattern of repeated unsubstantiated complaints of neglect and abuse per OAR chapter 411, division 020 and chapter 407, division 045;(d)
Failure to meet behavior consultant qualifications or continuing education requirements;(e)
Failure to provide copies of records to designated Department or Oregon Health Authority entities;(f)
Repeated failure to participate in Behavior Support Plan review or service planning meetings when requested by an individual’s case manager;(g)
Failure to provide the services noted in these rules; or(h)
Fraud or misrepresentation in the provision of services under these rules.(2)
Medicaid providers have rights to appeal a termination based on OAR 407-120-0360 (Consequences of Non-Compliance and Provider Sanctions)(8)(g) and, as applicable, OAR chapter 410, division 120.(3)
Medicaid providers of these services must provide 30 day written notice, or more if specified in contract, to the Department of the decision to cease services.
Source:
Rule 411-046-0190 — Disenrollment or Termination, https://secure.sos.state.or.us/oard/view.action?ruleNumber=411-046-0190.