Or. Admin. Code § 414-175-0085

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

Section 414-175-0085 - Direct Provider Payments

(1) The Department makes payments on behalf of eligible individuals to the providers they select to care for their children. The payments are made directly to the provider. To be eligible for payment, a provider must:

(a) Charge individuals receiving ERDC benefits at a rate no higher than the rate charged other customers;

(b) Provide the Department their social security number (SSN) or IRS identification number; and

(c) Meet the requirements of OAR 414-175-0080.

(2) Payments to a provider of an individual receiving ERDC benefits are subject to each of the following limitations:

(a) Before August 1, 2021, payment is made for child care already provided in the ERDC program for all providers except Certified Centers certified by the Office of Child Care who receive payment in advance for anticipated hours a child is in care for the month.

(b) Payment is made for the amount charged to the individual but may not exceed the rate authorized in OAR 414-175-0075.

(c) No payment will be authorized unless the individual has designated a primary provider.

(d) No payment will be made for less than one dollar.

(e) Except as provided otherwise in subsection (f) of this section, a payment is made only for child care provided on or after the date the designated provider has met the requirements to be listed and paid through the Department.

(f) A designated child care provider who the Department approves to be listed and paid through the Department may receive payment for child care provided prior to obtaining Department approval if the provider met the other Department requirements and was licensed under OAR 414-205-0000 to 414-205-0170, 414-350-0000 to 414-350-0405, 414-305-0100 to 414-305-1620, or 414-310-0100 to 414-310-0720.

(g) A caretaker signature is not required on child care billing forms.

(h) A provider caring for an eligible child may receive payment in advance for hours the child is scheduled to be in care for the month.

(3) The Department may issue a payment to an eligible provider during a month for which child care is being provided to meet an unexpected need of the provider related to the care of a covered child. The payment may be made if, without the payment, continued care by the same provider would be jeopardized and the client could not immediately obtain child care from another provider.

(4) Child care providers must submit claims for child care on the appropriate form designated by the Department.

(a) The provider is responsible to obtain the appropriate payment form from the Department and to return the completed form to the Direct Pay Unit of the Department; or

(b) If using the Department tracking system, the provider is responsible to ensure children are checked in and out appropriately and payment requests are submitted through the system.

(5) No payment will be made for:

(a) A paper claim not received by the Department by the last day of the third month after the form was issued unless the Department determines the provider had good cause for not returning the form timely.

(b) An electronic claim if the request is not submitted by the 10th of the month following the month care is provided unless the Department determines the provider has good cause for not submitting the electronic claim timely.

(6) Child care billing forms cannot be issued or reissued more than 12 months from the month that care was provided.

Or. Admin. Code § 414-175-0085

ELD 11-2023, adopt filed 06/28/2023, effective 7/1/2023; DELC 134-2024, amend filed 06/26/2024, effective 7/1/2024

Statutory/Other Authority: ORS 329A.500

Statutes/Other Implemented: ORS 329A.500