(2)(a) A health care provider that submits a claim for payment to the authority or a coordinated care organization shall wait to receive payment for at least 90 days after submitting the claim before assigning the claim to a collection agency or similar entity to recover from the patient.
(b) If the claim remains unpaid 90 days after a health care provider submits the claim to the authority or a coordinated care organization, the health care provider shall first query the medical assistance program database to confirm the patient’s eligibility for medical assistance.
(c) The health care provider may not assign the claim for collection if the authority confirms that the patient was eligible for medical assistance at the time the services were provided. [2017 c.287 §2]
Structure 2021 Oregon Revised Statutes
Volume : 11 - Juvenile Code, Human Services
Chapter 414 - Medical Assistance
Section 414.018 - Legislative intent; findings.
Section 414.025 - Definitions for ORS chapters 411, 413 and 414.
Section 414.033 - Expenditures for medical assistance authorized.
Section 414.034 - Acceptance of federal billing, reimbursement and reporting forms.
Section 414.041 - Simplified application process; outreach and enrollment.
Section 414.066 - Billing patient for services covered by medical assistance prohibited.
Section 414.071 - Timely payment for dental services.
Section 414.072 - Prior authorization data and reports.
Section 414.075 - Payment of deductibles imposed under federal law.
Section 414.109 - Oregon Health Plan Fund.
Section 414.115 - Medical assistance by insurance or service contracts; rules.
Section 414.117 - Premium assistance for health insurance coverage.
Section 414.125 - Rates on insurance or service contracts; requirements for insurer or contractor.
Section 414.135 - Contracts relating to direct providers of care and services.
Section 414.145 - Implementation of ORS 414.115, 414.125 or 414.135.
Section 414.150 - Purpose of ORS 414.150 to 414.153.
Section 414.152 - Duty of state agencies to work with local health departments.
Section 414.153 - Services provided by local health departments.
Section 414.211 - Medicaid Advisory Committee.
Section 414.221 - Duties of committee.
Section 414.227 - Application of public meetings law to advisory committees.
Section 414.312 - Oregon Prescription Drug Program.
Section 414.318 - Prescription Drug Purchasing Fund.
Section 414.325 - Prescription drugs; use of legend or generic drugs; prior authorization; rules.
Section 414.326 - Supplemental rebates from pharmaceutical manufacturers.
Section 414.327 - Electronically transmitted prescriptions; rules.
Section 414.328 - Synchronization of prescription drug refills.
Section 414.330 - Legislative findings on prescription drugs.
Section 414.332 - Policy for Practitioner-Managed Prescription Drug Plan.
Section 414.334 - Practitioner-Managed Prescription Drug Plan for medical assistance program.
Section 414.337 - Limitation on rules regarding Practitioner-Managed Prescription Drug Plan.
Section 414.351 - Definitions for ORS 414.351 to 414.414.
Section 414.353 - Committee established; membership.
Section 414.354 - Meetings; advisory committees; public notice and testimony.
Section 414.356 - Executive session.
Section 414.359 - Mental Health Clinical Advisory Group.
Section 414.364 - Intervention approaches.
Section 414.369 - Prospective drug use review program.
Section 414.371 - Retrospective drug use review program.
Section 414.372 - Pharmacy lock-in program; rules.
Section 414.382 - Requirements for annual report.
Section 414.414 - Use and disclosure of confidential information.
Section 414.426 - Payment of cost of medical care for institutionalized persons.
Section 414.428 - Coverage for American Indian and Alaska Native beneficiaries.
Section 414.430 - Access to dental care for pregnant women; rules.
Section 414.432 - Reproductive health services for noncitizens.
Section 414.500 - Findings regarding medical assistance for persons with hemophilia.
Section 414.510 - Definitions.
Section 414.520 - Hemophilia services.
Section 414.530 - When payments not made for hemophilia services.
Section 414.532 - Definitions for ORS 414.534 to 414.538.
Section 414.538 - Prohibition on coverage limitations; priority to low-income women.
Section 414.550 - Definitions for ORS 414.550 to 414.565.
Section 414.555 - Findings regarding medical assistance for persons with cystic fibrosis.
Section 414.560 - Cystic fibrosis services.
Section 414.565 - When payments not made for cystic fibrosis services.
Section 414.570 - System established.
Section 414.572 - Coordinated care organizations; rules.
Section 414.575 - Community advisory councils.
Section 414.578 - Community health improvement plan.
Section 414.581 - Tribal Advisory Council established; membership; terms.
Section 414.591 - Coordinated care organization contracts; financial reporting; rules.
Section 414.593 - Reporting and public disclosure of expenditures by coordinated care organizations.
Section 414.598 - Alternative payment methodologies.
Section 414.605 - Consumer and provider protections.
Section 414.609 - Network adequacy; member transfers.
Section 414.611 - Transfer of 500 or more members of coordinated care organization.
Section 414.613 - Discrimination based on scope of practice prohibited; appeals; rules.
Section 414.619 - Coordination between Oregon Health Authority and Department of Human Services.
Section 414.628 - Innovator agents.
Section 414.631 - Mandatory enrollment in coordinated care organization; exemptions.
Section 414.632 - Services to individuals who are dually eligible for Medicare and Medicaid.
Section 414.665 - Traditional health workers utilized by coordinated care organizations; rules.
Section 414.669 - Payment for doula services.
Section 414.686 - Health assessments for foster children.
Section 414.688 - Commission established; membership.
Section 414.689 - Members; meetings.
Section 414.690 - Prioritized list of health services.
Section 414.694 - Commission review of covered reproductive health services.
Section 414.695 - Medical technology assessment.
Section 414.698 - Comparative effectiveness of medical technologies.
Section 414.701 - Commission may not rely solely on comparative effectiveness research.
Section 414.706 - Persons eligible for medical assistance; rules.
Section 414.710 - Services not subject to prioritized list.
Section 414.712 - Health services for certain eligible persons.
Section 414.717 - Palliative care program; rules.
Section 414.719 - Housing navigation services and social determinants of health; rules.
Section 414.723 - Telemedicine services; rules.
Section 414.743 - Payment to noncontracting hospital by coordinated care organization; rules.
Section 414.755 - Payment for hospital services.
Section 414.756 - Payments to Oregon Health and Science University.
Section 414.762 - Payment for child abuse assessment.
Section 414.764 - Payment for services provided by pharmacy or pharmacist.
Section 414.766 - Behavioral health treatment; rules.
Section 414.770 - Participants in clinical trials.
Section 414.772 - Limits on use of step therapy.
Section 414.782 - Reimbursement to ensure access to addiction treatment statewide.
Section 414.815 - Law Enforcement Medical Liability Account; limited liability; rules; report.
Section 414.853 - Definitions.
Section 414.855 - Hospital assessment; rates; rules.
Section 414.857 - Reduction in rate required by federal law.
Section 414.863 - Refund of hospital assessment; right to contested case hearing.
Section 414.867 - Deposit of assessments collected to Hospital Quality Assurance Fund.
Section 414.869 - Establishment of Hospital Quality Assurance Fund.
Section 414.871 - Applicability of hospital assessment.
Section 414.880 - Managed care organization assessment; rate.
Section 414.882 - Refund of managed care organization assessment; right to contested case hearing.
Section 414.884 - Applicability of managed care organization assessment.
Section 414.900 - Hospital assessment; penalties.
Section 414.902 - Managed care organization assessment; penalties.