Chapter 414 Medical Assistance

Sections

414.018
Legislative intent; findings
414.025
Definitions for ORS chapters 411, 413 and 414
414.033
Expenditures for medical assistance authorized
414.034
Acceptance of federal billing, reimbursement and reporting forms
414.041
Simplified application process; outreach and enrollment
414.044
Notice to Department of Veterans’ Affairs of information regarding applications for health care coverage by uniformed service members and veterans; rules
414.065
Determination of health care and services covered; quality measures; reimbursement; cost sharing; payments by Oregon Health Authority as payment in full; rules
414.066
Billing patient for services covered by medical assistance prohibited
414.067
Coordinated care organization assumption of costs; reports to Legislative Assembly
414.071
Timely payment for dental services
414.075
Payment of deductibles imposed under federal law
414.095
Exemptions applicable to payments
414.109
Oregon Health Plan Fund
414.115
Medical assistance by insurance or service contracts; rules
414.117
Premium assistance for health insurance coverage
414.125
Rates on insurance or service contracts; requirements for insurer or contractor
414.135
Contracts relating to direct providers of care and services
414.145
Implementation of ORS 414.115, 414.125 or 414.135
414.150
Purpose of ORS 414.150 to 414.153
414.152
Duty of state agencies to work with local health departments
414.153
Services provided by local health departments
414.211
Medicaid Advisory Committee
414.221
Duties of committee
414.225
Oregon Health Authority to consult with committee
414.227
Application of public meetings law to advisory committees
414.231
Eligibility for Health Care for All Oregon Children program; 12-month continuous enrollment; verification of eligibility
414.312
Oregon Prescription Drug Program
414.314
Application and participation in Oregon Prescription Drug Program; prescription drug charges; fees
414.318
Prescription Drug Purchasing Fund
414.320
Rules
414.325
Prescription drugs; use of legend or generic drugs; prior authorization; rules
414.326
Supplemental rebates from pharmaceutical manufacturers
414.327
Electronically transmitted prescriptions; rules
414.328
Synchronization of prescription drug refills
414.329
Prescription drug benefits for certain persons who are eligible for Medicare Part D prescription drug coverage; rules
414.330
Legislative findings on prescription drugs
414.332
Policy for Practitioner-Managed Prescription Drug Plan
414.334
Practitioner-Managed Prescription Drug Plan for medical assistance program
414.337
Limitation on rules regarding Practitioner-Managed Prescription Drug Plan
414.351
Definitions for ORS 414.351 to 414.414
414.353
Committee established; membership
414.354
Meetings; advisory committees; public notice and testimony
414.356
Executive session
414.359
Mental Health Clinical Advisory Group
414.361
Committee to advise and make recommendations on drug utilization review standards and interventions; preferred drug list
414.364
Intervention approaches
414.369
Prospective drug use review program
414.371
Retrospective drug use review program
414.372
Pharmacy lock-in program; rules
414.381
Annual reports; educational materials; procedures to protect confidential information
414.382
Requirements for annual report
414.414
Use and disclosure of confidential information
414.426
Payment of cost of medical care for institutionalized persons
414.428
Coverage for American Indian and Alaskan Native beneficiaries
414.430
Access to dental care for pregnant women; rules
414.432
Reproductive health services for noncitizens
414.500
Findings regarding medical assistance for persons with hemophilia
414.510
Definitions
414.520
Hemophilia services
414.530
When payments not made for hemophilia services
414.532
Definitions for ORS 414.534 to 414.538
414.534
Treatment for breast or cervical cancer; eligibility criteria for medical assistance; rules
414.536
Presumptive eligibility for medical assistance for treatment of breast or cervical cancer
414.538
Prohibition on coverage limitations; priority to low-income women
414.540
Rules
414.550
Definitions for ORS 414.550 to 414.565
414.555
Findings regarding medical assistance for persons with cystic fibrosis
414.560
Cystic fibrosis services
414.565
When payments not made for cystic fibrosis services
414.570
System established
414.572
Coordinated care organizations; rules
414.575
Community advisory councils
414.577
Community health assessment and adoption of community health improvement plan; rules
414.578
Community health improvement plan
414.581
Tribal Advisory Council established; membership; terms
414.584
Meetings of coordinated care organization governing body to be open to public; recording and taking of minutes required
414.590
Coordinated care organization contracts; terms and amendments; 60 days’ advance notice; refusal to renew
414.591
Coordinated care organization contracts; financial reporting; rules
414.593
Reporting and public disclosure of expenditures by coordinated care organizations
414.595
External quality reviews of coordinated care organizations; limits on documentation and reporting requirements
414.598
Alternative payment methodologies
414.605
Consumer and provider protections
414.607
Use and disclosure of member information; access by member to personal health information
414.609
Network adequacy; member transfers
414.611
Transfer of 500 or more members of coordinated care organization
414.613
Discrimination based on scope of practice prohibited; appeals; rules
414.619
Coordination between Oregon Health Authority and Department of Human Services
414.628
Innovator agents
414.631
Mandatory enrollment in coordinated care organization; exemptions
414.632
Services to individuals who are dually eligible for Medicare and Medicaid
414.638
Metrics and scoring subcommittee; identification of outcome and quality measures and benchmarks
414.654
Persons served by prepaid managed care health services organizations; funding of health information technology
414.655
Utilization of patient centered primary care homes and behavioral health homes by coordinated care organizations
414.665
Traditional health workers utilized by coordinated care organizations; rules
414.667
Definition for ORS 414.667 to 414.669
414.668
Access to doula services
414.669
Payment for doula services
414.672
Tribal-based practices for mental health and substance abuse prevention, counseling and treatment
414.686
Health assessments for foster children
414.688
Commission established; membership
414.689
Members; meetings
414.690
Prioritized list of health services
414.694
Commission review of covered reproductive health services
414.695
Medical technology assessment
414.698
Comparative effectiveness of medical technologies
414.701
Commission may not rely solely on comparative effectiveness research
414.704
Advisory committee
414.706
Persons eligible for medical assistance; rules
414.709
Adjustment of population of eligible persons in event of insufficient resources prohibited
414.710
Services not subject to prioritized list
414.712
Health services for certain eligible persons
414.728
Reimbursement of rural hospitals on fee-for-service basis
414.735
Reduction in scope of health services in event of insufficient resources; approval of Legislative Assembly or Emergency Board; notice to providers
414.742
Payment for mental health drugs
414.743
Payment to noncontracting hospital by coordinated care organization; rules
414.745
Liability of health care providers and plans
414.755
Payment for hospital services
414.756
Payments to Oregon Health and Science University
414.760
Payment for patient centered primary care home and behavioral health home services
414.762
Payment for child abuse assessment
414.764
Payment for services provided by pharmacy or pharmacist
414.766
Behavioral health treatment; rules
414.770
Participants in clinical trials
414.772
Limits on use of step therapy
414.805
Liability of individual for medical services received while in custody of law enforcement officer
414.807
Oregon Health Authority to pay for medical services related to law enforcement activity; certification of injury
414.815
Law Enforcement Medical Liability Account; limited liability; rules; report
414.853
Definitions
414.855
Hospital assessment; rates; rules
414.857
Reduction in rate required by federal law
414.863
Refund of hospital assessment; right to contested case hearing
414.865
Audits
414.867
Deposit of assessments collected to Hospital Quality Assurance Fund
414.869
Establishment of Hospital Quality Assurance Fund
414.871
Applicability of hospital assessment
414.880
Managed care organization assessment; rate
414.882
Refund of managed care organization assessment; right to contested case hearing
414.884
Applicability of managed care organization assessment
414.900
Hospital assessment; penalties
414.902
Managed care organization assessment; penalties