Or. Admin. Code § 410-123-1660

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

Section 410-123-1660 - Meaningful Language Access

(1) Providers shall take reasonable steps to ensure that persons with Limited English Proficiency (LEP) have meaningful access and an equal opportunity to participate in program services at all dental care visits, including telehealth:

(a) The size or type of provider does not matter. All providers serving OHP members shall tell members that qualified health interpreter services are available free of charge. Interpreter services shall be timely and protect the privacy and independence of the person with LEP;

(b) Bilingual providers and staff may become Certified Health Care Interpreters after completing the requisite interpreter training and receiving a valid certificate from the Authority;

(c) The Authority's Health Care Interpreter Registry lists all qualified or certified Health Care Interpreters available for provider use;

(d) Fee-for-Service (FFS) dental providers may receive a $60 add-on fee, per date of service, for providing interpreter services to OHP members. The addition of this add-on fee for FFS visits does not change CCO requirements related to reimbursement of qualified and certified HCIs for interpretation services.

(2) FFS oral health and dental providers who furnish Certified Health Care Interpreter (HCI) services to OHP members are eligible to receive a $60 add-on fee per date of service. The Authority will cover this fee only when:

(a) The fee is billed in conjunction with a covered OHP service or medically necessary follow-up visit related to the initial Covered Service;

(b) The fee is not billed in conjunction with bundled rate services that incorporate administrative costs (e.g., inpatient hospital stays, home health or hospice visits, services provided by long-term care facilities, or services billed at an encounter rate by rural health clinics, federally qualified health centers and tribal health centers); and

(c) The language assistance service is provided by a qualified or Certified Health Care Interpreter as described in Oregon Revised Statute (ORS) Chapter 413.

(3) Billing: Providers shall verify that the interpreter is registered with the Authority's Health Care Interpreter Registry. If the interpreter is registered, providers pay the interpreter directly for services provided. After payment is made to the interpreter, bill the Authority for the add-on fee on the claim form:

(a) Use CDT code D9990 for dental visits;

(b) Use HCPCS code T1013 for medical visits;

(c) Add the code to a new line on the claim form;

(d) Keep Documentation in the member's medical record that indicates use of the qualified or certified Health Care Interpreter for any potential audit of services billed.

Or. Admin. Code § 410-123-1660

DMAP 50-2021, adopt filed 12/24/2021, effective 1/1/2022; DMAP 12-2022, minor correction filed 02/04/2022, effective 2/4/2022; DMAP 71-2024, minor correction filed 02/22/2024, effective 2/22/2024

Statutory/Other Authority: ORS 414.572 & 413.550

Statutes/Other Implemented: ORS 414.572 & 413.550