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Medical Assistance (General Rules) Program

Medical Assistance (General Rules) Program

Oregon Administrative Rules and supplemental information administered by the Division of Medical Assistance Programs.

Recent rule filings

You can sort or filter by document type or effective date. You can also view Medical Assistance (General Rules) Program rules as filed with the Secretary of State (please note that rules filed by the first of the month will not be posted on the Secretary of State website until the middle of the filing month).

  
  
File Description
  
Nprm-120-0000-09172015Notice of Rulemaking Hearing
410-120-0000
Consolidation of Managed Care Organization Definitions into Chapter 410-120-0000 General Programs Definition Rule
This is rulemaking, not a rulemaking hearing.
Last opportunity for public comment: Sept. 17, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
9/17/2015
120-0006-08202015Notice of Rulemaking Hearing
410-120-0006
Align with Department of Human Services OAR Chapter 461 Rules
There is no rulemaking hearing.
The end of the public comment period is August 20, 2015 at 5 p.m.
Send comments to dmap.rules@state.or.us.
8/20/2015
120-0006-07012015Permanent Rule Filing
410-120-0006
Align with Department of Human Services OAR Chapter 461 Rules
7/1/2015
120-changes-07012015Permanent Rule Filing
410-120-0025, 410-120-1280, 410-120-1360, 410-120-1510, 410-120-1560, 410-120-1960
Add Acronym for CCO Where PHP Referenced, Housekeeping, Codification, and Clarification of Overpayments Language
7/1/2015
Nprm-120-06162015Notice of Rulemaking Hearing
410-120-0025, 410-120-1280, 410-120-1360, 410-120-1510, 410-120-1560, 410-120-1960
Add Acronym for CCO Where PHP Referenced, Housekeeping, Codification, and Clarification of OVerpayments Language
Rulemaking Hearing: 6/16/15 at 10:30 a.m., Room 160
Last opportunity for public comment: 6/18/15 by 5 p.m.
Send comments to: dmap.rules@state.or.us
6/16/2015
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Administrative rulebooks

  
  
120rb0304153/4/2015
120rb0210152/10/2015
120rb0101151/1/2015
120rb10011410/1/2014
120rb0923149/23/2014
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Supplemental information and guidelines

Provider guides

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Provider Enrollment Handbook
General Rules Provider Guide, 9-26-2014
Prior Authorization Handbook
Employee Education about False Claims Recoveries

Fraud and abuse authorities

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Answer
You can also report fraud online. For more information, see the DHS frequently asked questions about reporting fraud.
 
Medicaid Fraud Control Unit (MFCU)
1515 SW 5th Avenue, Suite 410, Portland, OR 97201
Phone (971) 673-1880, or fax (971) 673-1890
Provider Audit Unit (PAU)
3406 Cherry Ave NE, Salem, OR 97303
Phone (888) 372-8301, or fax (503) 378-2577
Fraud Investigations Unit (FIU)
P.O. Box 14150, Salem, OR 97309-5027
Phone (888) 372-8301, or fax (503) 373-1525


Other resources

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Oregon primary care providers and procedure codes
Oregon Medicaid Third Party Liability Requirements
Eligibility Group categories
Questions and answers about client co-payments
2014 federal primary care codes and rates
Sample Oregon Health ID (formerly Medical Care ID)
Oregon Medicaid Vaccines for Children administration codes and rates
2013 federal primary care codes and rates
Provider Discrimination Review Process

Forms

  
  
DMAP 1074DMAP 1074 - Prior Authorization for Out-of-State Services
DMAP 3035DMAP 3035 - Provider Information Update
DMAP 3113DMAP 3113 - Provider Enrollment Short Form
DMAP 3162DMAP 3162 – AVR Quick Reference Guide
DMAP 3161DMAP 3161 - PWP eligibility verification screen
DHS 3970DHS 3970 - EDMS Cover Sheet
DMAP 3085DMAP 3085 - Request for Administrative Review
DMAP 3165DMAP 3165 - OHP Client Agreement to Pay for Health Services
DMAP 3165DMAP 3165 - OHP Client Agreement to Pay for Health Services
DMAP 3165DMAP 3165 - OHP Client Agreement to Pay for Health Services
DMAP 3165DMAP 3165 - OHP Client Agreement to Pay for Health Services

Who to call for help

Provider Services 800-336-6016 or email us
Address and telephone contacts

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