Chapter 414  Medical Assistance

General Provisions

§ 414.018 Legislative intent
§ 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

Medical Assistance

§ 414.065 Determination of health care and services covered
§ 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

Insurance And Service Contracts

§ 414.115 Medical assistance by insurance or service contracts
§ 414.125 Rates on insurance or service contracts
§ 414.135 Contracts relating to direct providers of care and services
§ 414.145 Implementation of ORS 414.115, 414.125 or 414.135

State And Local Public Health Partnership

§ 414.150 Purpose of ORS 414.150 to 414.153
§ 414.152 Duties of state agencies
§ 414.153 Services provided by local government

Advisory Committees

§ 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
§ 414.229 Office for Oregon Health Policy and Research Advisory Committee

Health Care For All Oregon Children Program

§ 414.231 Eligibility for Healthy Kids program

Prescription Drugs

(Oregon Prescription Drug Program)

§ 414.312 Oregon Prescription Drug Program
§ 414.314 Application and participation in Oregon Prescription Drug Program
§ 414.316 Preferred drug list for Oregon Prescription Drug Program
§ 414.318 Prescription Drug Purchasing Fund
§ 414.320 Rules

(Prescription Drug Coverage By Medical Assistance)

§ 414.325 Prescription drugs
§ 414.326 Supplemental rebates from pharmaceutical manufacturers
§ 414.327 Electronically transmitted prescriptions
§ 414.329 Prescription drug benefits for certain persons who are eligible for Medicare Part D prescription drug coverage

(Practitioner Managed Prescription Drug Plan)

§ 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

(Pharmacy And Therapeutics Committee)

§ 414.351 Definitions for ORS 414.351 to 414.414
§ 414.353 Committee established
§ 414.354 Meetings
§ 414.356 Executive session
§ 414.361 Drug utilization review standards and interventions
§ 414.364 Intervention approaches
§ 414.369 Prospective drug use review program
§ 414.371 Retrospective drug use review program
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Medical Assistance For Certain Individuals

§ 414.426 Payment of cost of medical care for institutionalized persons
§ 414.428 Coverage for American Indian and Alaskan Native beneficiaries
§ 414.440 Suspension of medical assistance provided to inmates

Medical Assistance Based On Condition

(Hemophilia)

§ 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

(Breast And Cervical Cancer)

§ 414.532 Definitions for ORS 414.534 to 414.538
§ 414.534 Treatment for breast or cervical cancer
§ 414.536 Presumptive eligibility for medical assistance for treatment of breast or cervical cancer
§ 414.538 Prohibition on coverage limitations
§ 414.540 Rules

(Cystic Fibrosis)

§ 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

Oregon Integrated And Coordinated Care Delivery System

(Prepaid Managed Care Health Services Organizations)

§ 414.610 Legislative intent
§ 414.615 Selection of providers
§ 414.618 Authorization for alternatives to reimbursement of coordinated care organizations

(Coordinated Care Organizations)

§ 414.620 System established
§ 414.625 Coordinated care organizations

(Temporary Provisions Relating To Transition Are Compiled As Notes Following Ors 414.625)

§ 414.631 Mandatory enrollment in coordinated care organization
§ 414.632 Services to individuals who are dually eligible for Medicare and Medicaid
§ 414.635 Consumer and provider protections
§ 414.638 Outcome and quality measures and benchmarks
§ 414.645 Network adequacy
§ 414.647 Transfer of 500 or more enrollees
§ 414.651 Coordinated care organization contracts
§ 414.653 Alternative payment methodologies
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(Health Evidence Review Commission)

§ 414.688 Commission established
§ 414.689 Members
§ 414.690 Prioritized list of 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

Scope Of Covered Health Services

§ 414.706 Legislative approval and funding of health services to certain persons
§ 414.707 Level of health services provided to certain persons
§ 414.708 Conditions for coverage for certain elderly persons, blind persons or persons who have disabilities
§ 414.709 Adjustment of population of eligible persons in event of insufficient resources
§ 414.710 Services not subject to prioritized list
§ 414.712 Health services for certain eligible persons
§ 414.721 Federal approval for funding services with assessments
§ 414.727 Reimbursement of rural hospitals by prepaid managed care health services organization
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Payment Of Medical Expenses Of Person In Custody Of Law Enforcement Officer

§ 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
§ 414.815 Law Enforcement Medical Liability Account

Premium Assistance

§ 414.825 Policy
§ 414.826 Private health option
§ 414.828 Assistance subject to legislative appropriation
§ 414.831 Expanding group coverage in Family Health Insurance Assistance Program
§ 414.839 Premium assistance for health insurance coverage
§ 414.841 Definitions for ORS 414.841 to 414.864
§ 414.842 Purpose
§ 414.844 Application to participate in program
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Hospital Assessment

(Temporary Provisions Relating To Hospital Assessment Are Compiled As Notes Following Ors 414.872)

Medicaid Managed Care Organization Assessment

(Temporary Provisions Relating To Medicaid Managed Care Organization Assessment Are Compiled As Notes Following Ors 414.872)