Or. Admin. Code § 461-185-0050

Current through Register Vol. 63, No. 11, November 1, 2024

Section 461-185-0050 - Patient Liability Pay-In System

(1) The Department ends all provisions in this rule on December 31, 2021.

(2) Except as provided in sections (3) and (4) of this rule, an individual who receives home and community-based care (see OAR 461-001-0030) in-home services and has countable income above the payment standard for the benefit group must pay to the Department the lesser of the following amounts as a condition of being eligible for home and community-based care in-home services:

(a) The individual's adjusted income (see OAR 461-160-0620).

(b) The actual cost of home and community-based care in-home services.

(3) The service liability of individuals in OSIPM-ICP is calculated in accordance with section (2) of this rule. Individuals in OSIPM-ICP do not pay the Department directly. The ICP service payment of these individuals will be reduced by the amount of their liability.

(4) An individual exempt from payments under OAR 461-160-0610 is exempt from the payment required by this rule.

(5) Each month, the Department will send the individual an invoice requesting payment based on the calculation in section (2) of this rule.

(6) Payments must be received by the Department in the month of service.

Or. Admin. Code § 461-185-0050

AFS 29-1994, f. 12-29-94, cert. ef. 1-1-95; AFS 11-2001, f. 6-29-01, cert. ef. 7-1-01; SSP 8-2005(Temp), f. & cert. ef. 7-1-05 thru 10-1-05; SSP 14-2005, f. 9-30-05, cert. ef. 10-1-05; SSP 19-2005, f. 12-30-05, cert. ef. 1-1-06; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP 15-2006, f. 12-29-06, cert. ef. 1-1-07; SSP 17-2013(Temp), f. & cert. ef. 7-1-13 thru 12-28-13; SSP 26-2013, f. & cert. ef. 10-1-13; SSP 37-2013, f. 12-31-13, cert. ef. 1-1-14; SSP 16-2021, minor correction filed 02/18/2021, effective 2/18/2021; SSP 79-2021, temporary amend filed 12/22/2021, effective 1/1/2022 through 6/29/2022; SSP 34-2022, amend filed 04/28/2022, effective 5/1/2022

Statutory/Other Authority: ORS 411.060, 411.070 & 411.404

Statutes/Other Implemented: ORS 411.060, 411.070 & 411.404