Suspension of medical assistance of persons with serious mental illness admitted to state hospital
(1) As used in this section:
(a) “Person with a serious mental illness” means a person who is diagnosed by a psychiatrist, a licensed clinical psychologist or a certified nonmedical examiner as having dementia, schizophrenia, bipolar disorder, major depression or other affective disorder or psychotic mental disorder other than a disorder caused primarily by substance abuse.
(b) “State hospital” has the meaning given that term in ORS 162.135 (Definitions for ORS 162.135 to 162.205).
(2) Except as provided in subsections (6) and (7) of this section, the Department of Human Services or the Oregon Health Authority shall suspend, instead of terminate, the medical assistance of a person with a serious mental illness when:
(a) The person receives medical assistance because of a serious mental illness; and
(b) The person is admitted to a state hospital.
(3) The department or the authority shall continue to determine the eligibility of the person for medical assistance.
(4) Upon notification that a person described in subsection (2) of this section is no longer residing in a state hospital or that the person is admitted to a medical institution outside of the state hospital for a period of hospitalization, the department or the authority shall reinstate the person’s medical assistance if the person is otherwise eligible for medical assistance.
(5) This section does not extend eligibility to an otherwise ineligible person or extend medical assistance to a person if matching federal funds are not available to pay for medical assistance.
(6) Subsection (2) of this section does not apply to a person with a serious mental illness residing in a state hospital who is under 22 years of age or who is 65 years of age or older.
(7) A person with a serious mental illness may apply for medical assistance between 90 and 120 days prior to the expected date of the person’s release from a state hospital. If the person is found to be eligible, the effective date of the person’s medical assistance shall be the date of the person’s release from the state hospital. [Formerly 414.424; 2011 c.207 §2; 2011 c.720 §109; 2013 c.688 §47; 2015 c.836 §2]
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