Or. Admin. Code § 410-151-0005

Current through Register Vol. 64, No. 1, January 1, 2025

Section 410-151-0005 - Referrals

(1) When a medical, behavioral health, nutritional, or dental condition is discovered during the EPSDT screening process, the EPSDT Beneficiary shall be referred to an appropriate provider for further diagnosis and, when EPSDT Medically Necessary and EPSDT Medically Appropriate (or EPSDT Dentally Appropriate), receive treatment.

(2) The screening provider shall explain the need for the referral to the EPSDT Beneficiary, and, when applicable, the EPSDT Beneficiary's parent or guardian.

(3) If the EPSDT Beneficiary, EPSDT Beneficiary's parent, guardian, or legal authority agrees to the referral, the referring provider shall offer assistance in finding an appropriate referral provider and making an appointment.

(4) The EPSDT Beneficiary's MCE or the Authority shall also make available care coordination as needed.

Or. Admin. Code § 410-151-0005

DMAP 97-2023, adopt filed 12/27/2023, effective 1/1/2024

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 414.025, 414.065 & 414.150