Or. Admin. Code § 414-175-0051

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

Section 414-175-0051 - Requirement to Make Copay or Satisfactory Arrangements

(1) The Need Group must use a child care provider who meets the requirements in OAR 414-175-0080 and 414-175-0085.

(2) The caretaker is responsible for paying the copayment to the primary provider of child care unless the Child Care Billing form was sent to the provider showing no copayment.

(3) If the caretaker has only one provider during a month, that provider is the primary provider. If the caretaker uses more than one provider, the caretaker must designate one as the primary provider. Notwithstanding any designation by the caretaker, the Department considers a provider having the copayment amount (not to exceed the caretaker's established copayment amount) deducted from its valid billing statement the primary provider for that period.

(4) If the copayment exceeds the amount billed by the primary provider, the Department may treat a different provider as the primary provider or split the copayment among the providers who bill for care.

(5) The copayment amount due from the caretaker to the provider is the lesser of:

(a) The copayment amount determined by the Department based on family size and income.

(b) The total amount allowed by the Department on a provider claim.

(6) A provider must notify the Department of an overdue copayment within 60 days after the Department issues payment for the month at issue. A caretaker who fails to pay a copayment to or to make satisfactory arrangements with the primary provider will be ineligible for ERDC benefits upon recertification. A copayment is considered paid under any of the following circumstances:

(a) On the first day of the month in which the caretaker makes the copayment or makes satisfactory arrangements with the provider.

(b) On the first day of the month after three years have lapsed from the date the caretaker failed to make the copayment.

(c) On the first day of the month in which the caretaker provides verification that the copayment debt was discharged by a bankruptcy filing.

(7) The Department will make the payment to a provider if a Child Care Billing form is mailed to the provider prior to the notification described in section (6) of this rule.

Or. Admin. Code § 414-175-0051

ELD 11-2023, adopt filed 06/28/2023, effective 7/1/2023

Statutory/Other Authority: ORS 329A.500

Statutes/Other Implemented: ORS 329A.500