When Medicare is the primary payer, services provided in the inpatient or out-patient setting do not require prior authorization. However, if the Division of Medical Assistance Programs (Division) is the primary payer because the service is not covered by Medicare; the prior authorization requirements listed in chapter 410 division 125 would apply.
Or. Admin. R. 410-125-0103
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 414.065