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DMAP Notices of Proposed Rulemaking and rulemaking hearings

OHP Notices of Proposed Rulemaking and rulemaking hearings

Oregon ​Administrative Rules adm​inistered by the Health Systems Division

Receive OHP rulemaking notices and hearings updates by e-mail  - Please specify which program(s) you are interested in; otherwise, you will receive updates for all programs.

 

Rulemaking process overview 

Before these notices are filed, the following meetings are held to discuss upcoming proposed rule changes. Meeting dates, locations and times are posted on the OHP meetings calendar:

Unless otherwise specified, the division holds rulemaking hearings at the Barbara Roberts Human Services Building, 500 Summer St NE, Salem. Visitors have several paid and metered parking options.

 

Questions?

Contact the Rules Coordinator (503-945-6430) to ask about proposed rule status and submitting public comment.

 

Rulemaking Hearing Notices

Click on the table header names to sort or filter the notices list.

  
Program Name
  
File Description
  
Nprm-172-0660-07192016Behavioral Health
410-172-0660
Board Registered/Licensed Interns to be included as Non-payable, Enrollable Medicaid Providers
Rulemaking Hearing: July 19, 2016, 10:30 a.m., Room 160
Last Opportunity for Public Comment: July 21, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
7/19/2016
Nprm-120-0006-06172016General Rules
410-120-0006
Align with Department of Human Services OAR Chapter 461 Rules
There is no hearing for this rule.
Last opportunity to comment: June 17, 2016, by 5 p.m.
Send comments to dmap.rules@state.or.us.
6/17/2016
Nprm-120-0000-06172016General Rules
410-120-0000
Update International Classification of Diseases Coding from ICD-9 to ICD-10 and Name Changes
There is no rulemaking hearing.
Last opportunity for public comment is June 17, 2016 by 5 p.m.
Send comments to dmap.rules@state.or.us.
6/17/2016
Nprm-133-06172016School-Based Health Services
410-133-0000, 410-133-0040, 410-133-0060, 410-133-0080, 410-133-0100, 410-133-0120, 410-133-0140, 410-133-0200, 410-133-0300, 410-133-0320
Clarify Services, Billing, Qualifications for Providing IDEA Services to Children with Disabilities in Public Schools
This is rulemaking and no rulemaking hearing.
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
6/17/2016
Nprm-165-06172016Medicaid EHR Incentive Program
410-165-0000, 410-165-0020, 410-165-0040, 410-165-0060, 410-165-0080, 410-165-0100, 410-165-0120, and 410-165-0140
EHR IP Rule Updates Following Federal Rule Update
This is not a rulemaking hearing.
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/17/2016
Nprm-141-3110-061516OHP (MCO and CCO)
410-141-3110
CCO Substance Use Disorder Provider, Treatment and Facility Certification and Licensure
Rulemaking Hearing: June 15, 2016, 10:30 a.m. Room 137B
Last opportunity for public comment: June 17 by 5 p.m.
Send comments to: dmap.rules@state.or.us
6/15/2016
Nprm-141-3262-061516OHP (MCO and CCO)
410-141-3262
Requirements for CCO Appeal
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last opportunity for public comment: June 17, 2016, by 5 p.m.
Send comments to: dmap.rules@state.or.us
6/15/2016
Nprm-141-3070-06152016OHP (MCO and CCO)
410-141-3070
Preferred Drug List Requirements
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last opportunity for comments: June 17, 2016, by 5 p.m.
Send comments to dmap.rules@state.or.us
6/15/2016
Nprm-123-1510-06152016Dental
410-123-1510
Timeframes for Seeing, Referring or Providing Services to OHP Fee-for-Service Pregnant Clients
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016, 5 p.m.
Send Comments: dmap.rules@state.or.us
6/15/2016
Nprm-121-0030-06152016Pharmaceutical Services
410-121-0030
Amending PDL November 19, 2015, January 28, 2016 DUR/P&T Action
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comments: June 17, 2016, 5 p.m.
Send Comments to: dmap.rules@state.or.us
6/15/2016
Nprm-121-0040-06152016Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016, 5 p.m.
Send Comments to: dmap.rules@state.or.us
6/15/2016
Nprm-125-06152016Hospital
410-125-0080, 410-125-0141, and 410-125-0400, 410-120-0000
Enroll and Reimburse Specialty Hospitals Classified as Long-Term Acute Care Hospitals
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-123-1060-06152016Dental
410-123-1060
Defines Medicament in the Context of Dental Rules
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016 by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-123-1260-06152016Dental
410-123-1260
Update Reference to Current Covered and Non-Covered Dental Services Document, Incorporate Changes and Corrections
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-141-061516OHP (MCO and CCO)
410-141-3060 and 410-141-3080
Amend CCO Enrollment and Disenrollment Rules Aligning Current Practices and Pregnancy Enrollment Exemption Processes
Rulemaking Hearing: June 15, 2016, 10:30 a.m. Room 137B
Last Opportunity for Public Comments: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-141-0000-06152016OHP (MCO and CCO)
410-141-0000
Definition Addition of Managed Care Entity (MCE)
Rulemaking Hearing: June 15, 2016, 10:30 a.m. Room 137B
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-141-3420-06152016NewOHP (MCO and CCO)
410-141-3420 and repeal 410-141-0420
Managed Care Entity (MCE) Billing and Payment
Rulemaking Hearing: June 15, 2016, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 17, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us.
6/15/2016
Nprm-200-0407-05172016OCCS
410-200-0407
Former Foster Care Youth Medical--Specific Requirements
Rulemaking Hearing: May 17, 2016, 10:30 a.m. Room 160
Last Opportunity for Public Comment: May 19, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
5/17/2016
Nprm-200-05172016OCCS
OAR 410-200-0015; 410-200-0100; 410-200-0105; 410-200-0110; 410-200-0111; 410-200-0115; 410-200-0120; 410-200-0125; 410-200-0130; 410-200-0135; 410-200-0140; 410-200-0200; 410-200-0215; 410-200-0230; 410-200-0235; 410-200-0240; 410-200-0310; 410-200-0415; 410-200-0425; 410-200-0440; 410-200-0505; 410-200-0510
Rulemaking Hearing: May 17, 2016, 10:30 a.m. Room 160
Last Opportunity for Public Comment: May 19, 2016, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
5/17/2016
Nprm-120-1280-04212016General Rules
410-120-1280
Update DMAP 3165 Form
There is no rulemaking hearing for this form change. No rule language changed.
Last opportunity for public comment: April 21, 2016 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
4/21/2016
Nprm-200-0315-04212016OCCS
410-200-0315
Income Eligibility Guidelines for OCCS Medical Programs
There is no hearing for this rule change since OARs must be amended to reflect the federally released FPLs as quickly as possible.
Last day for public comment: April 21, 2016 by 5 p.m.
Send comments to dmap.rules@state.or.us.
4/21/2016
Nprm-130-0220-04212016Medical-Surgical
410-130-0220
Incorporate Code Set and HERC Changes into List of Billing Codes Not Covered by OHP
There is no hearing for this rulemaking. The changes were made by CMS and HERC.
The public comment period ends April 21, 2016, at 5 p.m.
Send comments to dmap.rules@state.or.us.
4/21/2016
Nprm-141-3020-04212016OHP (MCO and CCO)
410-141-3020
Administration of Oregon Integrated and Coordinated Health Care Delivery System Regulation and Rule Precedence
This is a notice of proposed rulemaking with no hearing.
The last day for public comment is April 21, 2016, by 5 p.m.
Send comments to dmap.rules@state.or.us.
4/21/2016
Nprm-122-0211-03172016DME
410-122-0211
Remove ICD-9 Diagnosis Codes
3/17/2016
Nprm-121-0040-03152016Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: March 15, 2016, 10:30 a.m. Room 160
Last opportunity for public comment: March 17, 2016, by 5 p.m.
Send comments to: dmap.rules@state.or.us
3/15/2016
Nprm-122-02192016DME
410-122-0204, 410-122-0240, 410-122-0300, 410-122-0360, 410-122-0365, 410-122-0380, 410-122-0475, 410-122-0480, 410-122-0510, 410-122-0525, 410-122-0640, 410-122-0678
Adding PDF Links to Durable Medical Equipment (DMEPOS) Tables and Updating Rule Language
There will be no hearing for these rules.
Last day for public comment: February 19, 2016, by 5 p.m.
Send comments to: dmap.rules@state.or.us
2/19/2016
Nprm-170-0110-021916BRS
410-170-0110
Updating Behavioral Rehabilitation Services Rate Table Incorporated by Reference and Web Address
There is no rulemaking hearing for this rule.
The last day for public comment is February 19, 2016 by 5 p.m.
Send comments to dmap.rules@state.or.us 
2/19/2016
Nprm-141-0520-021916OHP (MCO and CCO)
410-141-0520
Prioritized List, Effective 1/1/16, including Modifications Effective 10/1/15 and Biennial Changes January 1, 2016-December 31, 2017
This is a rulemaking, not a rulemaking hearing.
Last opportunity for public comment is February 19, 2016 at 5 p.m.
Send comments to dmap.rules@state.or.us.
2/19/2016
Nprm-120-1340-02192016General Rules
410-120-1340
Annual Updates; Relative Value Unit (RVU) Weight; Clinical Lab, ASC
This is rulemaking, and there is no hearing.
Last Opportunity for Public Comment: February 19, 2016
Send comments to dmap.rules@state.or.us
2/19/2016
Nprm-121-0040-02172016Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: February 17, 2016, 10:30 a.m. Room 160
Last Opportunity for Public Comment: February 19, 2016, by 5 p.m.
Send Comments: dmap.rules@state.or.us
2/17/2016
Nprm-121-0030-02172016Pharmaceutical Services
410-121-0030
Amending PDL November 19, 2015 DUR/P&T Action
Rulemaking Hearing: February 17, 2016, 10:30 a.m. Room 160
Last Opportunity for Public Comment: February 19, 2016 by 5 p.m.
Send Comments: dmap.rules@state.or.us
2/17/2016
Nprm-122-0186-01222016DME
410-122-0186
Update Ostomy and Complex Rehabilitation Code Tables and Rule Language
There is no rulemaking hearing.
Last Opportunity for Public Comment: January 22, 2016 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
1/22/2016
Nprm-140-01202016Visual
410-140-0020, 410-140-0040, 410-140-0050, 410-140-0080, 410-140-0120, 410-140-0140, 410-140-0160, 410-140-0200, 410-140-0260, 410-140-0280, 410-140-0300 and repeal of 410-140-0400
Removing Prior Authorization (PA) Requirement on Deluxe Frames (V2025) and Removing Outdated Language
Rulemaking Hearing: January 20, 2016 at 10:30 a.m. in Room 160
Last Opportunity for Public Comment: January 22, 2016 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
1/20/2016
Nprm-141-3345-01202016OHP (MCO and CCO)
410-141-3345
General Financial Reporting and Financial Solvency Matters; CCO Reporting Method
Rulemaking Hearing: January 20, 2016 at 10:30 a.m. Room 160
Last Opportunity for Public Comment: January 22, 2016 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
1/20/2016
Nprm-141-3440-12172015OHP (MCO and CCO)
410-141-3440
Aligns Non-Emergent Medical Transportation Vehicle and Subcontractor Standards with New Statute Regarding Inhalants
There is no hearing for this rule.
Last opportunity for public comment: December 17 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
12/17/2015
Nprm-136-3040-12172015Medical Transportation
410-136-3040
Aligns Non-Emergent Medical Transportation Vehicle and Subcontractor Standards with New Statute Regarding Inhalants
There is no hearing for this rule.
Last opportunity to comment: December 17 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
12/17/2015
Nprm-121-0030-12172015Pharmaceutical Services
410-121-0030
Align Rule with Statute to Allow Reimbursement for Brand Name Version of a Covered Drug
There is no rulemaking hearing.
Last opportunity for public comment: December 17, 2015 by 5 p.m.
Send comments to dmap.rules@state.or.us
12/17/2015
Nprm-130-0200-12152015Medical-Surgical
410-130-0200
Begin to Require Prior Authorization for Payment of Gender Dysphoria Surgeries, OHP-FFS Program
Rulemaking Hearing: December 15, 2015 at 10:30 a.m. in Room 137C
Last Opportuity for Public Comment: December 17, 2015 at 5 p.m.
Send Comments: dmap.rules@state.or.us
12/15/2015
Nprm-121-0030-12152015Pharmaceutical Services
410-121-0030
Amending PDL March 26, May 28, 2015 DUR/P&T Action
Rulemaking Hearing: December 15, 2015 10:30 a.m. Room 137C
Last opportunity for public comment: December 17, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
12/15/2015
Nprm-141-3150-12152015OHP (MCO and CCO)
410-141-3150
Flexible Services, Definition, Direction and Reporting of Non-State Plan, Health Related Services
Rulemaking Hearing: December 15, 2015, 10:30 a.m., Room 137C
Last opportunity for public comment: December 17, 2015, by 5 p.m.
Send comments to: dmap.rules@state.or.us
12/15/2015
Nprm-121-0135-12152015Pharmaceutical Services
410-121-0135
Rewrite Rule to Implement House Bill 2306 (2015 Regular Session) for a Pharmacy Management Program
Rulemaking Hearing: December 15, 2015 at 10:30 a.m., Room 137C
Last Opportunity for Public Comment: December 17, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
12/15/2015
Nprm-121-12152015Pharmaceutical Services
410-121-0000, 410-121-0146
Implement Prescription Synchronization Policy for Medical Assistance Recipients Not Enrolled in a Coordinated Care Organization
Rulemaking Hearing: December 15, 2015 at 10:30 a.m. Room 137C
Last Opportunity for Public Comment: December 17, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
12/15/2015
Nprm-130-0200-OOH-12152015Medical-Surgical
410-130-0200
OHP FFS Program, Begin Requiring Prior Authorization for Billing Out-of-Hospital Birth Services
Rulemaking Hearing: December 15, 2015 at 10:30 a.m. in Room 137C
Last opportunity for public comments: December 17, 2015 at 5 p.m.
Send comments to dmap.rules@state.or.us.
12/15/2015
Nprm-141-3040-11172015OHP (MCO and CCO)
410-141-3040
Service Area Change for Existing CCOs
Rulemaking Hearing: November 17, 2015 at 10:30 a.m. in Room 137C
Extended Opportunity for Public Comment: December 18, 2015 at 5 p.m.
Send comments to: dmap.rules@state.or.us
11/17/2015
Nprm-141-3267-11172015OHP (MCO and CCO)
OAR 410-141-3267
Process for Resolving Disputes between CCOs and the Oregon Health Authority
Rulemaking Hearing: November 17, 2015
Last Opportunity for Public Comment: November 19, 2015 at 5 p.m.
Send comments to: dmap.rules@state.or.us
11/17/2015
Nprm-121-0030-11172015Pharmaceutical Services
410-121-0030
Amending PDL March 26, May 28, 2015 DUR/P&T Action
Rulemaking Hearing: November 17, 2015 at 10:30 a.m. in Room 137C (was incorrectly stated as Room 166).
Last Opportunity for Public Comment: November 19 by 5 p.m.
Send Comments: dmap.rules@state.or.us
11/17/2015
Nprm-121-0040-11172015Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: November 17, 2015 at 10:30 a.m. in Room 137C (incorrectly stated as Room 166).
Last Opportunity for Public Comment: November 19, 2015 by 5 p.m.
Send Comments: dmap.rules@state.or.us
11/17/2015
NPRM-141-10172015OHP (MCO and CCO)
410-141-0000, 410-141-0080, 410-141-0160, 410-141-0220, 410-141-0320, 410-141-0340, 410-141-0420, 410-141-0860, 410-141-3080 and the repeal of 410-141-0085, 410-141-0410, 410-141-0660, 410-141-0680, 410-141-0700, 410-141-0720, 410-141-0740, 410-141-0760, 410-141-0780, 410-141-0800, 410-141-0820, 410-141-0840
PCCM Program Dissolution of Rules and Program References
This is not a rulemaking hearing.
The end of the public comment period is October 17, 2015 by 5 p.m.
10/17/2015
Nprm-123-1240-11172015Dental
410-123-1240
Update Reference to Current ADA Dental Claim Form
There is no rulemaking hearing.
The last opportunity for public comment is October 17, 2015 by 5 p.m.
Send comments to dmap.rules@state.or.us.
10/17/2015
Nprm-123-10172015Dental
410-123-1220 and 410-123-1260
Update Reference to Current Covered and Non-Covered Dental Services Document; Incorporate Changes to Prioritized List
This is not a rulemaking hearing.
Last opportunity for public comment: October 17, 2015 by 5 p.m.
Send comments to dmap.rules@state.or.us.
10/17/2015
Nprm-130-0220-10152015Medical-Surgical
410-130-0220
Revision to List of Medical Billing Codes Excluded from Payment under OHP's FFS Program
Rulemaking Hearing: October 15, 2015 at 10:30 a.m. in Room 165
Last opportunity for public comment: October 17, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us
10/15/2015
Nprm-122-0658-10152015DME
410-122-0658
Amend Rule to Meet Requirements of the HERC Guideline Expanding Coverage of Lymphedema Conditions
The table is amended to remove codes that are no longer valid and add codes that will be covered.
Rulemaking Hearing: October 15, 2015, 10:30 a.m.
Location: 500 Summer St. NE, Salem, OR 97301 Room 165
Last Opportunity for Comment: Public comment period ends October 17 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
10/15/2015
Nprm-122-0040-10152015DME
410-122-0040
Amend Rule to Describe Prior Authorization Requirements for Clients Enrolled in CCOs
Rulemaking Hearing: October 15, 2015, 10:30 a.m. in Room 165
Last Opportunity for Public Comment: October 17, 2015 at 5:30 p.m.
Send Comments to: dmap.rules@state.or.us
10/15/2015
Nprm-122-0660-10152015DME
410-122-0660
Amend Rule to Add Reference to Other Applicable Rules and to Update Tables
Rulemaking Hearing: October 15, 2015 at 10:30 a.m. in Room 165
Last Opportunity for Public Comment: October 17, 2015 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
10/15/2015
Nprm-122-0630-10152015DME
410-122-0630
Amend Rule to Add Coverage for New Incontinence Product and to Update the Table
Rulemaking Hearing: October 15, 2015 at 10:30 a.m. in Room 165
Last Opportunity for Public Comment: October 17, 2015 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
10/15/2015
Nprm-121-0040-10152015Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: October 15, 2015 at 10:30 a.m. Room 165
Last Opportunity for Public Comment: October 17, 2015 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
10/15/2015
Nprm-120-0000-09172015General Rules
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
Nprm-141-0000-09172015OHP (MCO and CCO)
410-141-0000
Consolidation of Managed Care Organization Definitions into Chapter 410-120-0000 General Programs Definition Rule
This is rulemaking, not a rulemaking hearing.
Last opporotunity for public comment: Sept. 17, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
9/17/2015
Nprm-050-09172015Tax Rules
OAR 410-050-0700, 410-050-0710, 410-050-0720, 410-050-0730, 410-050-0740, 410-050-0750, 410-050-0760, 410-050-0770, 410-050-0780, 410-050-0790, 410-050-0800, 410-050-0810, 410-050-0820, 410-050-0830, 410-050-0840, 410-050-0850, 410-050-0860, 410-050-0861, 410-050-0870
Hospital Assessment Sunset Date Change; Update Language in Rules to Match Oregon Law
This is not a rulemaking hearing; however, the public comment period will end September 17, 2015, at 5 p.m.
You may submit comments to dmap.rules@state.or.us.
9/17/2015
NPRM-120-148-09172015AI/AN, Dental, DME, FQHC-RHC, General Rules, Home EPIV, Home Health, Hospital, Medical-Surgical, OHP (MCO and CCO), Pharmaceutical Services, Physical and Occupational Therapy, School-Based Health Services, Speech-Hearing
Update International Classification of Diseases Coding from ICD-9 to ICD-10
This is not a rulemaking hearing; however, the public comment period will end September 17, 2015, at 5 p.m.
You may submit comments to dmap.rules@state.or.us.
9/17/2015
Nprm-200-0440-09152015OCCS
410-200-0440
Specific Requirements; Extended Medical Assistance
Rulemaking Hearing: September 15, 2015, 10:30 a.m.,
Room 160
Last Opportunity for Public Comment: September 17, 2015,
5 p.m.
Send Comments to: dmap.rules@state.or.us
9/15/2015
120-0006-08202015General Rules
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
121-0030-08182015Pharmaceutical Services
410-121-0030
Preferred Drug List March 26, 2015 DUR/P&T Action
Rulemaking Hearing: August 18, 2015, 10:30 a.m., Room 160
Last opportunity for public comment: August 20, 2015, 5 p.m.
Send comments to: dmap.rules@state.or.us.

8/18/2015
121-0040-08182015Pharmaceutical Services
410-121-0040
Prior Authorization Approval Criteria Guide
Rulemaking Hearing: August 18, 2015, 10:30 a.m., Room 160
Last opportunity for public comment: August 20, 2015, 5 p.m.
Send comments to: dmap.rules@state.or.us
8/18/2015
141-3066-08182015OHP (MCO and CCO)
410-141-3066
CCO Enrollment for Adults and Young Adults Receiving Temporary Out-of-Area Behavioral Health Treatment
Rulemaking hearing: August 18, 2015 at 10:30 a.m.
Last opportunity for public comment: August 20, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us
8/18/2015
Nprm-132-07152015Private Duty Nursing
OAR 410-132-0020; 410-132-0030; 410-132-0060; 410-132-0070; 410-132-0080; 410-132-0100; 410-132-0120, 410-132-0180, and 410-132-0200 and repeal OAR 410-132-0050
Update Age Limitation, Identify Three PDN Programs, Update Benefit Package, Add CCOs
Rulemaking Hearing: July 15, 10:30 a.m. Room 137D
Last opportunity for public comment: July 17 by 5 p.m.
7/15/2015
Nprm-120-06162015General Rules
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
Nprm-148-06162015Home EPIV
410-148-0260
Clarifying Women, Infants and Children (WIC) and Oregon Health Plan (OHP) Payer Responsibility of Enteral Nutritional Formula
Rulemaking Hearing: June 16, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: June 18, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
6/16/2015
Nprm-120-0006-051815General Rules
410-120-0006
Align with Department of Human Services OAR Chapter 461 Rules
There is no rulemaking hearing.
End of public comment: 05/18/2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us.
5/18/2015
Nprm-172-051515Behavioral Health
410-172-0600 through 410-172-0850
Adopt new rules: Medicaid Payment for Behavioral Health Services
Rulemaking Hearing: May 15, 2015 at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301 Room 166
Last Opportunity for Public Comment: May 18, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
5/15/2015
Nprm-141-051515OHP (MCO and CCO)
410-141-0120 and 410-141-3120
Clarification of Credentialing Approval and Denial Protocol and Provider Discrimination Recourse Process
Rulemaking Hearing: May 15, 2015, 10:30 a.m., Room 166
Last Opportunity for Public Comment: May 18, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
5/15/2015
Nprm-121-0030-05152015Pharmaceutical Services
410-121-0030
Amending PDL January 29, 2015 DUR/P&T Action
Rulemaking Hearing: May 15, 2015 at 10:30 a.m. in Room 166
Last opportunity for public comment: May 18, 2015 by 5 p.m.
Send comments to: dmap.rules@state.or.us
5/15/2015
Nprm-121-0040-05152015Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: May 15, 2015 10:30 a.m., Room 166
Last Opportunity for Public Comment: May 18, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
5/15/2015
Nprm-123-041715-No HearingDental
410-123-1220 and 410-123-1260
Update Reference to Current Covered and Non-Covered Dental Services Document, Incorporate Changes to Prioritized List
There will be no rulemaking hearing.
The last opportunity for public comment is April 17, 2015.
Send comments to dmap.rules@state.or.us.
4/17/2015
Nprm-200-0315-041515OCCS
410-200-0315
Income Eligibility Guidelines for OCCS Medical Programs
Rulemaking Hearing: April 15, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: April 17, 5 p.m.
Send Comments to: dmap.rules@state.or.us
4/15/2015
Nprm-121-0030-041515Pharmaceutical Services
410-121-0030
Amending PDL November 20, 2014 DUR/P&T Action
4/15/2015
Nprm-122-0187-031715DME
410-122-0187
Adopt New Rule to Allow DME Repurposing Program Required by the Legislature
Rulemaking Hearing: March 17, 2015, 10:30 a.m. Room 160
Last Opportunity for Public Comment: March 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-165-031715Medicaid EHR Incentive Program
410-165-0000, 410-165-0020, 410-165-0040, 410-165-0060, 410-165-080, 410-165-0100
Amend Rules Governing Payment for Medicaid EHR Incentive Program
Rulemaking Hearing: March 17, 2015 at 10:30 a.m., Room 160
Last Opportunity for Public Comment: March 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-141-0520-031715OHP (MCO and CCO)
410-141-0520
Amendment of HERC Prioritized List of Health Services Effective 1/1/15 Incorporating Approved Modifications Effective 10/1/14
Rulemaking Hearing: March 17, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: March 19, 2015, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-130-0160-031715Medical-Surgical
410-130-0160
Allow Use of Medical Billing Codes Designated for Adaptive Behavior Assessment and Treatment Services
Rulemaking Hearing: March 17, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: March 19, 2015, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-121-0040-031715Pharmaceutical Services
410-121-0040
Amending Prior Authorization Approval Criteria Guide
Rulemaking Hearing: March 17, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: March 19, 2015, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-141-3268-031715OHP (MCO and CCO)
410-141-3268
Change Title of Rule to Better Reflect the Intent of the Rule
Rulemaking Hearing: March 17, 2015, 10:30 a.m. Room 160
Last Opportuntiy for Public Comment: March 19, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-141-3269-031715OHP (MCO and CCO)
410-141-3269
Add a Dispute Resolution Process for Existing CCOs and HCEs
Rulemaking Hearing: March 17, 2015 10:30 a.m. Room 160
Last Opportunity for Public Comment: March 19, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-122-0187-031715-SON ChangeDME
410-122-0187
Adopt Rule to Allow DME Repurposing Program Required by the Legislature
Rulemaking Hearing: March 17, 2015, 10:30 a.m., Room 160
Last Opportunity for Public Comment: March 19, 5 p.m.
Send Comments to: dmap.rules@state.or.us
3/17/2015
Nprm-120-1340-021915General Rules
410-120-1340
Annual Update for Relative Value Unites, Clinical Lab and Ambulatory Surgical Centers
There is no rulemaking hearing.
Last Day for Public Comment: February 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/19/2015
Nprm-143-021915HIV/AIDS Prevention
410-143-80020, 410-143-0040, 410-143-0060
Repeal Outdated HIV/AIDS Prevention Program Rules Now Administered by Public Health in Chapter 333
There will be no rulemaking hearing.
Last Opportunity for Public Comment: February 19, 2015 by 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/19/2015
Nprm-141-021715-EnrollmentOHP (MCO and CCO)
410-141-0060 and 410-141-3060
Rewrite OHP Enrollment Rules to Reflect Current Enrollment Practices Including Full Pregnancy Enrollment Exemption Process
Rulemaking Hearing: February 17, 2015, 10:30 a.m., 500 Summer St. NE, Salem, OR 97301, Room 166
Last Opportunity for Public Comment: February 19, 2015 by 5 p.m.


2/17/2015
Nprm-121-0030-021715Pharmaceutical Services
410-121-0030
Amending PDL May 29, July 31, 2014 DUR/P&T Action
Rulemaking Hearing: February 17, 2015, at 10:30 a.m. Hearing Room 166
Last Opportunity for Public Comment: February 19, 2015 by 5 p.m.
Submit Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-122-0209-021715DME
410-122-0209
Tracheostomy Rule Amendment Requiring Additional Documentation
Rulemaking Hearing: February 17, 2015 at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301, Room 166
Last Opportunity for Public Comment: February 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-141-021715-MaterialsOHP (MCO and CCO)
410-141-0280, 410-141-0300, 410-141-3280, 410-141-3300
Update and Align OHP Member Educational/Information Rules Affecting Members and Potential Members
Rulemaking Hearing: February 17, 2015, at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301 Room 166.
Last Opportunity for Public Comment: February 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-130-0200-0220-021715Medical-Surgical
410-130-0200 and 410-130-0220
Remove Not Covered Status from Billing Codes and Add Prior Authorization Requirement
Rulemaking Hearing: February 17, 2015 at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301 Room 166
Last Opportunity for Public Comment: February 19, 2015 at 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-121-0030-021715-Sept 23 2014Pharmaceutical Services
410-121-0030
Amending PDL Sept 23, 2014 DUR/P&T Action
Rulemaking Hearing: February 17, 2015, at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301 Room 166
Last Day for Public Comment: Febraury 19, at 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-121-0040-021715-PA Nov 20 2014Pharmaceutical Services
410-121-0040
Amending Prior Authorization Guide DUR/P&T Action Nove 20, 2014 Meeting
Rulemaking Hearing: February 17, 2015 at 10:30 a.m., 500 Summer St NE, Salem, OR 97301 Room 166.
Last Day for Public Comment: February 19, 2015, by 5 p.m.
Send Comments to: dmap.rules@state.or.us
2/17/2015
Nprm-121-0040-011515Pharmaceutical Services
410-121-0040
Amending Prior Authorization Guide DUR/P&T Action Sept. 23, 2014
Rulemaking Hearing: January 15, 2015, at 10:30 a.m., Room 160
Last Opportunity for Public Comment: January 17, 2015, by 5 p.m.
Submit Comments: dmap.rules@state.or.us
1/15/2015
Nprm-200-011515OCCS
410-200-0010 through 410-200-0510
Eligibility Requirements for the Authority's Office of Client and Community Services Medical Programs
Rulemaking Hearing: January 15, 2015 at 10:30 a.m. Room 160
Last Opportunity for Public Comment: January 17, 2015 by 5 p.m.
Submit Comments to: dmap.rules@state.or.us
1/15/2015
Nprm-141-0520-121614OHP (MCO and CCO)
410-141-0520
Amendment of HERC Priortized List of Health Services Reflecting Approved Modifications Effective October 1, 2014
There is no hearing for this rule.
Last Day for Public Comment is December 18, 2014, by 5 p.m.
Send comments to: dmap.rules@state.or.us.
12/18/2014
Nprm-122-0202-121614DME
410-122-0202
Rule Rewritten to Ensure Language Is Consistent with HERC Coverage Guidelines
Rulemaking Hearing: December 16, 2014, at 10:30 a.m. Room 137C
Last opportunity for public comment: December 18, 2014, at 5 p.m.
Send written comments to: dmap.rules@state.or.us
12/16/2014
Nprm-122-0520-121614DME
OAR 410-122-0520
Amend Rule to Ensure Language Is Consistent with HERC Coverage Guidelines
Rulemaking Hearing: December 16, 2014, at 10:30 a.m., Room 137C
Last opportunity for public comment: December 18, 2014, at 5 p.m.
Send written comments to: dmap.rules@state.or.us
12/16/2014
Nprm-122-0080-121614DME
410-122-0080
Amend Rule to Clarify Review Process for Items Not Already Identified as Covered by DMAP
Rulemaking Hearing: December 16, 2014, at 10:30 a.m. in Room 137C
Last opportunity for public comment: December 18, 2014, at 5 p.m.
Send written comments to: dmap.rules@state.or.us.
12/16/2014
nprm-050-0861-112114Tax Rules
AMEND - OAR 410-050-0861
REPEAL - OAR 410-050-0861 (T)
Increase hospital assessment rate from 5.30% to 5.80% effective October 1, 2014
Last opportunity for public comment: November 20, 2014 by 5 p.m. Send comments to dmap.rules@state.or.us.

11/21/2014
Nprm-130-0240-111814Medical-Surgical
410-130-0240
Precluded Payment for Out-of-Hospital Birth in High Risk Pregnancies
Rulemaking Hearing: November 18, 2014 at 10:30 a.m., Room 137C
Last opportunity for public comment: November 20, 2014, by 5 p.m.
11/18/2014
Nprm_141_111814OHP (MCO and CCO)
AMEND: 410-141-0420 and OAR 410-141-3420
REPEAL: 410-141-0420(T) and OAR 410-141-3420(T)
PHP and CCO Payment Methodologies for A & B Hospitals
Rulemaking Hearing: November 18, 2014 at 10:30 AM, Room 137C
Last Opportunity for Public Comment: November 20, 2014, by 5 p.m. Send comments to: dmap.rules@state.or.us.
11/18/2014
Nprm-141-3060-111814OHP (MCO and CCO)
AMEND:  OAR 410-141-3060
REPEAL: OAR 410-141-3060(T)
Revise CCO Enrollment Requirement and Remove Sunset Date for Third Trimester Pregnancy Exemption
Last Opportunity for Public Comment: November 20, 2014, by 5 p.m. Send comments to dmap.rules@state.or.us
11/18/2014
Nprm-131-0080-101514Physical and Occupational Therapy
OAR 410-131-0080
Amend Rule Text for Clarity and Ensure Language Is Consistent with Division Prior Authorization Requirements
Rulemaking Hearing: October 15, 2014, at 10:30 a.m., Rm. 137B.
Last Opportunity for Public Comment: October 17, 2014, by 5 p.m. Send comments to: dmap.rules@state.or.us.
10/15/2014
Nprm-200-091814OCCS
410-200-0145 and 410-200-0146
Final Orders, Dismissals, and Withdrawals; Contested Case Appeals
Notice of Proposed Rulemaking
Last Day for Public Comment: September 18, 2014, by 5 p.m.
E-mail: dmap.rules@state.or.us
9/18/2014
Nprm-120-091614General Rules
OAR 410-120-0000, 410-120-1160, 410-120-1200, 410-120-1230, 410-120-1260
Revise OHP Exclusions, Definitions, Copayment Table, and Codification Corrections
Rulemaking Hearing: September 16, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: September 18, 2014, by 5 p.m. Send comments to: dmap.rules@state.or.us 
9/16/2014
Nprm-123-1260-091614Dental
OAR 410-123-1260
Expand Oral Health Services in Medical Settings by Opening D0191 for Children under Age Six
Rulemaking Hearing: September 16, 2014
Last Opportunity for Public Comment: September 18, 2014 at 5 p.m.
Send comments to: dmap.rules@state.or.us
9/16/2014
Nprm-121-0040-091614Pharmaceutical Services
410-121-0040
Amending Prior Authorization Guide - March 27, May 29, July 31, 2014 DUR/P&T Action
Rulemaking Hearing: September 16, 2014, 10:30 a.m., Room 173B
Last Opportunity for Public Comment: September 18, 2014, by 5 p.m.
9/16/2014
Nprm-122-0260-091614DME
410-122-0260
Home Uterine Monitoring Rule Rewritten for Clarity
Rulemaking Hearing: September 16, 2014, 10:30 a.m., Room 137 B
Last Opportunity for Public Comment: September 18, 2014, by 5 p.m.
E-mail: dmap.rules@state.or.us
9/16/2014
Nprm-122-0640-091614DME
410-122-0640
Eye Prostheses Rule Rewritten for Clarity
Rulemaking Hearing: September 16, 2014, at 10:30 a.m., Room 137B
Last Opportunity for Public Comment: September 18, 2014, by 5 p.m.
E-mail: dmap.rules@state.or.us
9/16/2014
Nprm-125-0162-091614Hospital
OAR 410-125-0162
Establish an Incentive Payment Program for Hospitals Meeting Specific Performance Standards
Rulemaking Hearing: September 16, 2014, at 10:30 a.m., Room 137B
Last Opportunity for Public Comment: September 18, 2014, at 5 p.m.
E-mail: dmap.rules@state.or.us
9/16/2014
Nprm-121-0149-081914Pharmaceutical Services
REPEAL 410-121-0149
Medicaid Prescription Drug Assistance for Fully Dual Eligible Medicare Part D Clients
OAR 410-121-0149 was an emergency rule adopted in response to difficulties related to the roll-out of Medicare Part D. In January 2006, thousands of Oregonians who were dually eligible for Medicare and Medicaid were unable to fill prescriptions because pharmacies could not confirm their Medicare Part D eligibility. OAR 410-121-0149 provided relief by allowing pharmacies to obtain DMAP reimbursement. The issues have since been resolved. This rule is being repealed as it is no longer needed.
8/19/2014
Nprm-121-0030-081514Pharmaceutical Services
OAR 410-121-0030
Preferred Drug List March 27, 2014 DUR/P&T Action
Rulemaking Hearing: August 15, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: August 19, 2014, by 5 p.m. Send comments to dmap.rules@state.or.us
8/15/2014
Nprm-121-0040-081514Pharmaceutical Services
OAR 410-121-0040
Prior Authorization Guide - March 27, May 29, 2014 DUR/P&T Action
Rulemaking Hearing: August 15, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comments: August 19, 2014 by 5 p.m. Send comments to dmap.rules@state.or.us
8/15/2014
Nprm-200-0315-061714OCCS
410-200-0315
Income Eligibility Guidelines for OCCS Medical Programs
Rulemaking Hearing: June 17, 2014, at 10:30 a.m., Room 137B
Last opportunity for public comment: June 20, 2014, by 5 p.m.
6/17/2014
Nprm-120-1140-061714General Rules
410-120-1140
Including Additional Form Number as a Temporary Medicaid ID
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
6/17/2014
136-3010-061714Medical Transportation
410-136-3010
Adopts OAR 410-136-3010 Regarding the Relationship of Coordinated Care Organizations and Non-Emergent Medical Transportation
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014 by 5 p.m.
Send comments to: dmap.rules@state.or.us
6/17/2014
Nprm-123-061714Dental
410-123-1060, 410-123-1200, 410-123-1260, 410-123-1540
Eliminate OHP Standard; Expand Age Fluoride in Medical Setting; Incorporate Changes to Prioritized List
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
6/17/2014
Nprm-121-0030-061714Pharmaceutical Services
410-121-0030
Amending PDL-May 23, July 25, September 26, 2013, and January 30, 2014 DUR/P&T Action, and SR Contract Updates
Rulemaking Hearing: June 17, 2014, at 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
6/17/2014
Nprm-121-0040-061714Pharmaceutical Services
410-121-0040
Amending Prior Authorization Guide - May 23, July 25, September 26, 2013, and January 30, March 27, 2014 DUR/P&T Action
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014 by 5 p.m.
6/17/2014
Nprm-130-0200-061714Medical-Surgical
410-130-0200
Revision to Fee-For-Service Medicaid rule; Additional Services Will Require Prior Authorization
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
6/17/2014
Nprm-141-061714OHP (MCO and CCO)
Adopt New Rules: OAR 410-141-3435, 410-141-3440, 410-141-3445, 410-141-3450, 410-141-3455, 410-141-3460, 410-141-3465, 410-141-3470, 410-141-3475, 410-141-3480, and 410-141-3485
Add Non-Emergent Medical Transportation (NEMT) Language for Integration into Coordinated Care Organization Benefit Package
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
Send comments to dmap.rules@state.or.us
6/17/2014
Nprm-141-0000-061714OHP (MCO and CCO)
OARs 410-141-0000, 410-141-0050, 410-141-0120, 410-141-0180, 410-141-0270, 410-141-0410, 410-141-420, 410-141-0480, 410-141-0740, 410-141-3010, 410-141-3015, 410-141-3050, 410-141-3120, 410-141-3145, 410-141-3200, 410-141-3270
Amendment to program updates: marketing, benefits, assessment plan, measures and enrollment
Rulemaking Hearing: June 17, 2014, 10:30 a.m., Room 137B
Last Opportunity for Public Comment: June 20, 2014, by 5 p.m.
6/17/2014
Nprm-141-052114OHP (MCO and CCO)
410-141-0263, 410-141-3260
Revise Form Number and Title of DMAP 1234 Referenced in Rules
5/21/2014
121-0040-051514Pharmaceutical Services
410-121-0040
PA Criteria-May 23, July 25, Sept 26, Nov 21, 2013 Jan 30, 2014 DUR/P and T Action
Rulemaking Hearing: May 15, 2014, 10:30 a.m., Room 166
Last Opportunity for Public Comment: May 20, 2014, by 5 p.m.
Send comments to: dmap.rules@state.or.us
5/15/2014
121-0030-051514Pharmaceutical Services
410-121-0030
PDL-May 23, July 25, Sept 26, Nov 21, 2013 Jan 30, 2014 DUR/P and T Action, SR Contracts
Rulemaking Hearing: May 15, 2014, at 10:30 a.m. Room 166
Last Opportunity for Public Comment: May 20, 2014, by 5 p.m.
Send comments to: dmap.rules@state.or.us
5/15/2014
Nprm-141-0520-051514OHP (MCO and CCO)
410-141-0520
Amendment of HERC Prioritized List of Health Services Reflecting Approved Modifications Effective April 1, 2014
Rulemaking Hearing: May 15, 2014, 10:30 a.m., Room 166
Last opportunity for public comment: May 20, 2014 by 5 p.m.
5/15/2014
Nprm-122-0186-051514DME
410-122-0186
Rebasing Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Reimbursement Levels
Rulemaking Hearing: May 15, 2014 at 10:30 a.m. Room 166
Last opportunity for public comment: May 20, 2014 by 5 p.m.
5/15/2014
Nprm-141-3070-051514OHP (MCO and CCO)
410-141-3070
Allow for CCOs to Pay for Outpatient and Physician Administered Medications
Rulemaking Hearing: May 15, 2014 at 10:30 a.m., Room 166
Last opportunity for public comment: May 20, 2014 by 5 p.m.
5/15/2014
Nprm-136-041614Medical Transportation
410-136-3000, 410-136-3020, 410-136-3060, 410-136-3140, 410-136-3220, 410-136-3240
Extends Deadline to Change Non-emergent Medical Transportation Program; Makes Technical Changes
Rulemaking Hearing: April 16, 2014 at 10:30 a.m. in Room 137B
Last opportunity for public comment: April 18, 2014 by 5 p.m.
4/16/2014
Nprm-140-041614Visual Services
410-140-0020, 0040, 0050, 0120, 0140, 0160, 0200, 0260, 0280, 0300, and 0400 and repealing 410-140-0060, 0110, 0180, 0210, 0220, 0240, 0320 and 0380.
Reorganize Rule Text for Clarity and Amend Rule Ensuring Consistency with Division Reimbursement Methodology
Rulemaking Hearing: April 16, 2014, at 10:30 a.m., Conference Room 137B.
Last opportunity for public comment: 04/18/04 by 5 p.m.
Send comments to: dmap.rules@state.or.us
4/16/2014
Nprm-141-041614OHP (MCO and CCO)
410-141-0080 and 410-141-3080
Add "Without Cause" to CCO, FCHP, PCP and DCO Disenrollment Criteria Pursuant to Federal Regulations
Rulemaking Hearing: April 16, 2014, at 10:30 a.m., Room 137B.
Last Opportunity for Public Comment: April 18, 2014, by 5 p.m.
Send comments to dmap.rules@state.or.us.
4/16/2014
Nprm-141-3268-041614OHP (MCO and CCO)
410-141-3268
Add Arbitration Language for HCE and CCO Contracting Disputes
Rulemaking Hearing: April 16, 2014, at 10:30 am. in Conference Room 137B
Last opportunity for public comment: April 18, 2014, at 5 p.m.
Send written comments to dmap.rules@state.or.us
4/16/2014
Nprm-120-0006-032514General Rules
410-120-0006 Align with Department of Human Services OAR Chapter 461 Rules
Last opportunity for public comment: March 25, 2014, by 5:00 p.m.
E-mail: dmap.rules@state.or.us
3/25/2014
Nprm-050-031814Tax Rules
410-050-0100 through 410-050-0250
Repeal of Health Insurers' Tax Rules
The Oregon Health Authority, Division of Medical Assistance Programs is repealing the Health Insures' Tax rules because their sunset date was October 1, 2013, and they are no longer in effect.
Proposed rules are available on the following website: http://www.oregon.gov/DHS/admin/Pages/dwssrules/index.aspx. For hardcopy requests, call (503) 947-5250.
3/21/2014
Nprm-050-0870-031814Tax Rules
410-050-0870
Hospital Assessment Sunset Date Change
The Oregon Health Authority, Division of Medical Assistance Programs is amending OAR 410-050-0870 to reflect the new sunset date of the hospital assessment as approved by the Oregon State Legislature, effective August 1, 2013. The original sunset date expired October 1, 2013, and if the date is not changed to reflect the new date of October 1, 2015, the Authority will be unable to collect the hospital assessment, which funds the Oregon Health Plan. Permanent filing of this rule will repeal the temporary rule currently in place through March 29, 2014. Contact: (503) 947-5250.
3/21/2014
Nprm-120-1340-032014General Rules
410-120-1340 Annual Relative Value Unit (RVU) Weight Update Effective January 1, 2014
Last opportunity for public comment: March 20, 2014, by 5:00 p.m.
E-mail: dmap.rules@state.or.us
3/20/2014
Nprm-multiple-032014AI/AN, Dental, DME, FQHC-RHC, General Rules, Home EPIV, Home Health, Hospice, Hospital, Medical-Surgical, OHP (MCO and CCO), Physical and Occupational Therapy, Private Duty Nursing, Speech-Hearing, Targeted Case Management
Elimination of Oregon Health Plan Standard Benefit Plan Effective January 1, 2014
Amending and Repealing Rules in DMAP
Last opportunity for public comment: March 20, 2014, by 5:00 p.m.
E-mail Comments: dmap.rules@state.or.us
3/20/2014
Nprm-129-031814Speech-Hearing
410-129-0020, 410-129-0065, 410-129-007
Reorganize Rule Text for Clarity and Amend Rules to Ensure Consistency with Federal Rules
Rulemaking Hearing: March 18, 2014, at 10:30 a.m., 500 Summer St. NE, Salem, OR 97301, Room 137B
Last Opportunity for Public Comment: March 20, 2014, at 5 p.m.
3/18/2014
Nprm-130-0255-021814Medical-Surgical Services
410-130-0255 Immunization, Vaccines for Children and Immune Glogulins Rule Rewritten Clarifying Language and Removing Table
Rulemaking Hearing: February 18, 2014 at 10:30 a.m. Room 137B
Last opportunity for public comment: February 20, 2014 by 5:00 p.m.
2/18/2014
Nprm-200-021814Client and Community Services Medical
Adopt 410-200-0010 through 410-200-0510 and Repeal 410-200-0505(T) and 410-200-0406(T)
Eligibility Requirements for the Authority's Office of Client and Community Services Medical Programs
Rulemaking Hearing: February 18, 2014 at 10:30 a.m., Room 137B
Last opportunity for public comment: February 20, 2014 by 5:00 p.m.
2/18/2014
Nprm-136-3260-021814Medical Transportation
410-136-3260 Amends Modifications Based on Client Circumstances to Medical Transportation for Recipients of Medical Assistance Programs
Rulemaking Hearing: February 18, 2014 at 10:30 a.m., Room 137B
Last opportunity for public comment: February 20, 2014 by 5 p.m.
E-mail: dmap.rules@state.or.us
2/18/2014
nprm-120-0006 011614General Rules
410-120-0006 Notice of Proposed Rulemaking
Align with Department of Human Services OAR Chapter 461, medical eligibility rules
Last opportunity for written comment: January 16, 2014
Send comments to: sandy.c.cafourek@state.or.us
1/16/2014
nprm-141-0520-011514Oregon Health Plan (MCO and CCO)
410-141-0520 - Amendment of HERC Prioritized List of Health Services reflecting approved modifications effective October 1, 2013

Rulemaking hearing:  1/15/14 at 10:30 a.m. Room 137C
Last opportunity for public comment: 1/17/14 by 5:00 p.m.
1/15/2014
Nprm-141-011514Oregon Health Plan (MCO and CCO)
410-141-0065 and 410-141-3065
Rules related to Substance Use Disorder Residential Treatment Managed Care Enrollment Process and Procedures
Rulemaking Hearing: January 15, 2014, 10:30 a.m., Room 137C
Last opportunity for public comment: January 17, 2014, by 5 p.m.
E-mail Rules Coordinator: sandy.c.cafourek@dhsoha.state.or.us
1/15/2014
nprm-121-0111-011514Pharmaceutical Services
410-121-0111 Amend Pharmacy and Therapeutics Committee rule to remove expiration date and clarity given to safety
Rulemaking Hearing: January 15, 2014, 10:30 a.m., Room 137C
Last opportunity for public comment: January 17, 2014, by 5 p.m.
Send written comments to: sandy.c.cafourek@state.or.us
1/15/2014
Nprm-180-121813Traditional Health Worker Program
410-180-0325 and 410-180-0326 Traditional Health Worker Certification and Registry Application and Renewal Process and Background Check Requirements
Rulemaking Hearing: 12/18/13 at 10 a.m., 827 NE Oregon St., Suite 250, Portland, OR
Last opportunity for public comment: 12/20/13 by 5 p.m.
12/18/2013
Nprm-120-0003-121713General Rules
410-120-0003 OHP standard benefit plan is eliminated effective January 1, 2014
Rulemaking Hearing: 12/17/2013 at 10:30 a.m., Room 137C
Last opportunity for public comment: 12/19/2013 by 5:00 p.m.
12/17/2013
Nprm-130-0015-121713Medical-Surgical Services
410-130-0015 Payment process for doula services provided at the time of labor and delivery
Rulemaking Hearing: 12/17/2013 at 10:30 am., Room 137C
Last opportunity for public comment: 12/19/2013 by 5:00 p.m.
12/17/2013
Nprm-120-121713General Rules
410-120-0000, 410-120-0045, 410-120-1160, 410-120-1200, 410-120-1210, 410-120-1855
Add definitions, Change chemical dependency to substance use disorder, detox services available in other settings
Rulemaking Hearing: December 17, 2013, 10:30 a.m., Room 137C
Last opportunity for public comment: December 19, 2013, by 5 p.m. Send written comments to: sandy.c.cafourek@state.or.us
12/17/2013
Nprm-123-1260-120613Dental Services
410-123-1260 Expand age for varnish in medical setting and update language for dental integration. Revises language based on Health Evidence Review Commission's Prioritized List changes for October 1, 2013. Clarifies billing to avoid ambiguity regarding the responsibility of Coordinated Care Organizations (CCO).

Rulemaking public comment: Written public comment period extended to December 6, 2013, by 5:00 p.m.
12/6/2013
nprm-123-1260-111513Dental Services
410-123-1260 – Expand age for varnish in medical setting and update language for dental integration

Rulemaking hearing:  11/15/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 11/18/13 by 5:00 p.m.
11/15/2013
nprm-120-0030-111513General Rules
410-120-0030 – Statewide CHIP-funded CAWEM prenatal program 

Rulemaking hearing:  11/15/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 11/18/13 by 5:00 p.m.
11/15/2013
nprm-120-101513General Rules
410-120-1280, 410-120-1300, 410-120-1400 and 410-120-1860 - Align claim filing with CCO rules, clarify language for billing clients, technical corrections for forms

Rulemaking hearing: 10/15/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 10/17/13 by 5:00 p.m.
10/15/2013
nprm-170-101513Behavior Rehabilitation Services
OAR 410-170-0000, 410-170-0010, 410-170-0020, 410-170-0030, 410-170-0040, 410-170-0050, 410-170-0060,
410-170-0070, 410-170-0080, 410-170-0090, 410-170-0100, 410-170-0110 and 410-170-0120 - Describe program requirements for Behavior Rehabilitation Services Program

Rulemaking hearing: 10/15/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 10/17/13 by 5:00 p.m.
Proposed effective date: 1/1/14
10/15/2013
nprm-141-101513Oregon Health Plan (MCO and CCO)
–  410-141-0262, 410-141-0263, 410-141-0265, 410-141-0420,410-141-3260, 410-141-3263, 410-141-3395
and 410-141-3420 - Rules related to client appeals/hearings, provider requirements related to billing clients for non-covered services

Rulemaking hearing: 10/15/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 10/17/13 by 5:00 p.m.
10/15/2013
nprm-130-091713General Rules, Medical-Surgical Services
410-130-0005, 410-130-0255, 410-120-1340 - Increase payment for certain primary care practitioners and increase the VFC administration fee

Rulemaking hearing: 9/17/2013, 10:30 a.m, Room 137C
Last opportunity for public comment: 9/19/2013, 5 p.m.
9/17/2013
nprm-165-091713Medicaid EHR Incentive Program
410-165-0000, 410-165-0020, 410-165-0060, 410-165-0080, 410-165-0100, 410-165-0120 and 410-165-0140 - Amend rules governing payment for Medicaid EHR Incentive Program

Rulemaking hearing: 9/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 9/19/2013, 5 p.m.
9/17/2013
nprm-120-0006-081613General Rules
410-120-0006 - Align with OAR chapter 461, medical eligibility rules

Rulemaking hearing: 8/16/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 8/19/2013, 5 p.m.
8/16/2013
nprm-123-081613Dental Services
410-123-1160, 410-123-1260, 410-123-1490, 410-123-1600 - Add CCO language for dental integration

Rulemaking hearing: 8/16/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 8/19/2013, 5 p.m.
8/16/2013
nprm-125-0450-081613Hospital Services
410-125-0450 - Revise Health Care-Acquired Conditions policy to include Critical Access Hospitals.

Rulemaking hearing: 8/16/2013, 10:30 a.m., Room 137C
Last opporutnity for public comment: 8/19/2013, 5 p.m.
8/16/2013
nprm-141-081613Oregon Health Plan (MCO and CCO)
410-141-0262 and 410-141-3262 - Amend rules to be consistent with 42 CFR 438.408

Rulemaking hearing: 8/16/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 8/19/2013, 5 p.m.
8/16/2013
nprm-141-DCO-081613Oregon Health Plan (MCO and CCO)
410-141-3060, 410-141-3080, 410-141-3320, 410-141-3420 - Add DCO language for dental integration

Rulemaking hearing: 8/16/2013, 10:30 a.m., Room 137C
Last opportunity for rulemaking hearing: 8/19/2013, 5 p.m.
8/16/2013
nprm-121-071713Pharmaceutical Services
410-121-0030 and 410-121-0040 - Amending Preferred Drug List and Prior Authorization Guide - January 31, 2013 DUR/P&T Action

Rulemaking hearing: 7/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 7/19/2013, 5 p.m.
7/17/2013
nprm-120-00-061713General Rules
410-120-0000, 410-120-0025 and 410-120-0045 - Add definitions, clarify client billings, include Cover Oregon in application process, technical revision rule precedence.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 7/1/13
6/17/2013
nprm-120-1210-061713General Rules
410-120-1210 - Add definitions, Change in coverage to Part D Medicare for certain drugs

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 6/29/13
6/17/2013
nprm-121-0190-061713Pharmaceutical Services
410-121-0190 – Change in Clozaril Monitoring coding and re-write rule for clarity.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 6/25/13
6/17/2013
nprm-127-061713Home Health Services
410-127-0020, 410-127-0040, 410-127-0060 and 410-127-0080 - Clarify current practices in rule, provide rule language clarification for home health services.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 7/1/13
6/17/2013
nprm-130-061713Medical-Surgical Services
410-130-0180 and 410-130-0240 - Align with other rules referenced; establish clarity, and change in coding for pharmacy clozaril monitoring.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 6/25/13
6/17/2013
nprm-141-3060-061713Oregon Health Plan (MCO and CCO)
410-141-3060 - Correct the Authority’s intent to exempt newly eligible third trimester women from mandatory enrollment

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 6/29/13
6/17/2013
nprm-141-3160-061713Oregon Health Plan (MCO and CCO)
410-141-3160 - Supported Employment Services Definitions and Provider Requirements and Fidelity Reviews.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 7/2/13
6/17/2013
nprm-147-0360-061713FQHC-RHC
410-147-0360 - Add Alternative Payment Methodology (APM) pilot sites for FQHC and RHC

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 8/27/13
6/17/2013
nprm-147-0400-061713FQHC-RHC
410-147-0400 - Change method of payment to FQHC and RHC Out Station Outreach Worker Activities.

Rulemaking hearing: 6/17/13 at 10:30 a.m. Room 137C
Last opportunity for public comment: 6/19/13 by 5:00 p.m.
Proposed effective date: 6/29/13
6/17/2013
nprm-142-061713Hospice Services
410-142-0020, 410-142-0290 - Implement Federal and state requirements in nursing facility with payment rate changes rule language clarification

Rulemaking hearing: 6/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 6/19/2013, 5 p.m.
6/17/2013
nprm-165-061713Medicaid EHR Incentive Program
410-165-0000, 410-165-0020, 410-165-0040, 410-165-0060, 410-165-0080, 410-165-0100, 410-165-0120, 410-165-0140 - Amend rules governing payment for Medicaid EHR Incentive Program

Rulemaking hearing: 6/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 6/19/2013, 5 p.m.
6/17/2013
nprm-136-051513Medical Transportation
410-136-3000, 410-136-3020, 410-136-3040, 410-136-3060, 410-136-3080, 410-136-3100, 410-136-3120, 410-136-3140, 410-136-3160, 410-136-3180, 410-136-3200, 410-136-3220, 410-136-3240, 410-136-3260, 410-136-3280, 410-136-3300, 410-136-3320, 410-136-3340, 410-136-3360, 410-136-380 - Medical Transportation for Recipients of Medical Assistance Programs

Rulemaking hearing: 5/15/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 5/17/2013, 5 p.m.
5/15/2013
nprm-138-0390-041713Targeted Case Management
410-138-0390 - Targeted Case Management Retroactive Payments

Rulemaking hearing: 4/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 4/19/2013, 5 p.m.
4/17/2013
nprm-141-3260-041713Oregon Health Plan (MCO and CCO)
410-141-3260 - Amend CCO rules to include Authority’s intent for member's options to file grievance or complaint

Rulemaking hearing: 4/17/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 4/19/2013, 5 p.m.
4/17/2013
nprm-123-031513Dental Services
410-123-1060, 410-123-1160, 410-123-1200, 410-123-1220, 410-123-1240, 410-123-1260, 410-123-1490, 410-123-1620 - April 1, 2013 Dental Services rule changes for clarification and new CDT codes

Rulemaking hearing: 3/15/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 3/19/2013, 5 p.m.
3/15/2013
nprm-141-3080-031513Oregon Health Plan (MCO and CCO)
410-141-3080 - Authority requirements for approving transfer of 500 or more members from one CCO to another.

Rulemaking hearing: 3/15/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 3/19/2013, 5 p.m.
3/15/2013
nprm-120-0006-021513General Rules
410-120-0006: Align with OAR chapter 461, division 155 medical eligibility rules

Rulemaking hearing: 2/15/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 2/20/2013, 5 p.m.
2/15/2013
nprm-141-0520-021513Oregon Health Plan (MCO and CCO)
410-141-0520 - Amendment of HERC Prioritized List of Health Services reflecting approved modifications effective October 1, 2012

Rulemaking hearing: 2/15/2013, 10:30 a.m., Room 137C
Last opportunity for public comment: 2/20/2013, 5 p.m.
2/15/2013
nprm-121-110912Pharmaceutical Services
410-121-0111, 410-121-0030, 410-121-0033, 410-121-0040, and 410-121-0100 - Permanent adoption of the Pharmacy and Therapeutics Committee, Prior Authorization Guide and Preferred Drug List

Rulemaking hearing: 12/18/2012, 10:30 a.m., Room 137C
Last opportunity for public comment: 12/20/2012, 5 p.m.
12/18/2012
nprm-122-110912DME
410-122-0186 and 410-122-0325 - Amendment of DMEPOS rules due to legislative buyback and additional budget reductions

Rulemaking hearing: 12/18/2012, 10:30 a.m., Room 137C
Last opportunity for public comment: 12/20/2012, 5 p.m.
12/18/2012
nprm-120-0006-111912General Rules
OAR 410-120-0006 - Align with Department of Human Services OAR chapter 461, medical eligibility rules.

Rulemaking hearing: 11/19/2012 at 10:30 a.m. Room 137C
Last opportunity for public comment: 11/21/12 by 5:00 p.m.
Proposed effective date: 1/1/13
11/19/2012
nrpm-120-061512General Rules
410-120-0000, 410-120-0025, 410-120-0250, 410-120-1260, 410-120-1340, 410-120-1395 - Revisions to definitions, Program Integrity, Provider Enrollment, and technical corrections

Rulemaking hearing: 6/15/2012, 10:30 a.m., Room 137C
Last opportunity for public comment: 6/17/2012, 5 p.m.
Proposed effective date: July 1, 2012
6/15/2012
nprm-120-1295-031912General Rules
410-120-1295 - FCHP Non-contracted Hospital reimbursement rate methodology change

Rulemaking hearing: 3/19/2012, 10:30 a.m., Room 137C

Last opportunity for public comment: 3/20/2012
3/19/2012
120-0030-021512General Rules
410-120-0030 - CHIP Prenatal care expansion to include Umatilla County

Rulemaking hearing: 3/19/2012 at 10:30 a.m., Room 137C
Last opportunity for public comment: 3/21/12 by 5:00 p.m.
3/19/2012
nprm-121-031912Pharmaceutical Services
410-121-0030 and 410-121-0040 - Amending Preferred Drug List and Prior Authorization Guide - January 26, 2012 DUR/P&T Action

Rulemaking Hearing: 3/19/2012, 10:00 a.m., Room 137C
Last opportunity for public comment: 3/21/2012, 5 p.m.
3/19/2012
nprm-122-031912DME
410-122-0340, 410-122-0540, 410-122-0630, 410-122-0660 - Amending to update HCPCS codes, and clarify when documentation is required for authorization

Rulemaking hearing: 3/19/2012, 10 a.m., Room 137C
Last opportunity for public comment: 3/21/2012, 5 p.m.
3/19/2012
nprm-141-146-147-031912American Indian/Alaska Native, FQHC-RHC, Oregon Health Plan (MCO and CCO)
410-141-0860, 410-147-0362, 410-146-0020 - Patient-Centered Primary Care Home program revisions and clarifications

Rulemaking hearing: 3/19/2012, 10 a.m., Room 137C
Last opportunity for public comment: 3/21/2012, 5 p.m.
3/19/2012