Or. Admin. Code § 410-165-0120

Current through Register Vol. 63, No. 12, December 1, 2024

Section 410-165-0120 - Appeals

(1) The appeals process for the Program is governed by 42 CFR 495.370 and the Authority's Provider Appeals Rules in chapter 410, division 120.

(2) Pursuant to 42 CFR 495.312 and 42 CFR 495.370, the Authority may have CMS conduct the audits and handle any subsequent appeals of whether eligible hospitals are meaningful EHR users.

(3) A provider who applies for a Medicaid EHR incentive payment may appeal the Program's decision. Appeals are governed by the Division's Provider Appeal Rules OAR chapter 410, division 120. The provider's appeal shall note the specific reason for the appeal, due to one or more of the following issues:

(a) An incentive payment;

(b) An incentive payment amount;

(c) A provider eligibility determination;

(d) The demonstration of adopting, implementing, or upgrading; or

(e) Meaningful use eligibility other than a meaningful use eligibility issue where CMS handles the appeal, as provided in section (2) of this rule.

Or. Admin. Code § 410-165-0120

DMAP 13-2011, f. 6-29-11, cert. ef. 7-1-11; DMAP 20-2013(Temp), f. & cert. ef. 4-26-13 thru 10-23-13; DMAP 56-2013, f. & cert. ef. 10-22-13; DMAP 21-2016(Temp), f. 5-11-16, cert. ef. 5-13-16 thru 11-8-16; DMAP 47-2016, f. 7-18-16, cert. ef. 8/1/2016

Stat. Auth.: ORS 413.042

Stats. Implemented: ORS 413.042 & 414.033