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574 (07/2026) Chapter 2:Eligibility • Section 11: Medical Related Payments (MRP) Payment for a household item is not allowed if the CBC facility is required to provide the item by contract or administrative rule. This includes payment for lift chairs if the other requirements for this special need are met. Payment is not allowed if the item or service may be provided under any other special needs rule in this section. These payments do not need to be approved in advance by central office staff. Examples: • Purchase of a lift chair, or • The cost of moving out-of-state when $1,000 or less is sufficient (see Moving costs above). Note: If moving costs are more than $1,000 for an out-of-state move, a request for approval must be sent to the APD Policy box prior to issuing the payment. Contact APD Policy at APD.MedicaidPolicy@odhsoha.oregon.gov if you have any questions. Oregon Administrative Rule(s) 461-155-0710 — Special Need; Diversion Services; OSIP and OSIPM Prescription drug co-pay coverage For an OSIPM individual who is receiving SSI income: • ODHS|OHA will provide a payment for all Medicare Part D or Veteran’s Administration Health Care prescription co-pays if an individual’s co-pays exceed $10 per month. • Payment for Medicare Part D co-pays is limited to the current Low-Income Subsidy (LIS) program amounts for a fully dual eligible individual under 100 percent of the Federal Poverty Limit. • If the payment exceeds $30 per month, central office staff must approve it. This only has to be approved once. If the amount changes and is still over $30, it must be approved again.
If payment approval is needed by central office, a ONE task is generated. If approved and the issuance type is revolving fund check, another ONE task is generated for the financial clerk. Leadership will communicate the determination to the case manager, if applicable (IM, email, etc.). Note: For mail order prescriptions, a co-pay covering three-months of prescriptions must be calculated as a monthly amount for the payment. Oregon Administrative Rule(s) 461-155-0688 — Prescription Drug Co-pay Coverage In-home supplement For OSIPM, ODHS|OHA may provide a supplementary payment for an individual who meets the following requirements: • The individual must receive SSI as their only source of income.