Or. Admin. Code § 416-335-0040

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

Section 416-335-0040 - Prior Authorization for the BRS Program; Appeal Rights

(1) BRS Program Eligibility:

(a) OYA may provide prior authorization for the BRS Program to a person who:

(A) Meets the requirements in subsections (2)(a)(A) through (D) of OAR 410-170-0040; and

(B) Is in the legal custody and care of OYA.

(b) Notwithstanding section (1)(a) of this rule, OYA may provide prior authorization to a person who:

(A) Is a Child or Young Person;

(B) Meets the requirements in subsections (2)(a)(B) through (C) of OAR 410-170-0040;

(C) Is in the legal custody and care of OYA; and

(D) Is eligible for state-funded medical assistance through OYA but not eligible for Medicaid.

(2) Appeal Rights:

(a) If a person is denied prior authorization for the BRS Program under OAR 416-335-0040(1)(a) then the person is entitled to notice and contested hearing rights under 410-120-1860 and 410-120-1865. The contested case hearing will be held by the Authority.

(b) If a person is denied prior authorization for the BRS Program by OYA under OAR 416-335-0040(1)(b), then the person is entitled to notice and contested hearing rights pursuant to the provisions of ORS 183.341. The contested case hearing will be held by OYA. OYA adopts the Attorney General's Model Rules of Procedure OAR 137-003-0001 to 137-003-0091 and 137-003-0580, effective January 2012, as procedural rules for contested case hearings.

Or. Admin. Code § 416-335-0040

OYA 3-2013, f. 11-15-13, cert. ef. 1-1-14; OYA 16-2018, amend filed 12/27/2018, effective1/1/2019

Statutory/Other Authority: ORS 420A.025

Statutes/Other Implemented: ORS 420A.010 & ORS 420A.014