reglab/housing_qa huggingface dataset:
56 OK Stat § 56-1011.6 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.6. Disease management program.

|A. The Oklahoma Health Care Authority shall develop a formal program for disease management to improve the quality of care and reduce the cost of care. The Authority is authorized to contract for the development of the program if contracting is more cost effective to the state than developing the program internally. The disease management program may utilize pharmacy services including, but not limited to, Medication Management Therapy. The program may include, but not be limited to, asthma, diabetes, chronic obstructive pulmonary disease, renal disease and/or congestive heart failure. |The disease management program shall consist of:1. Claims data analysis;2. Population selection and targeting;3. Intervention through educational tools for patients and providers and treatment guidelines for physicians;4. Quality measurements of program structure, performance indicators, and outcome measures; and5. Reporting of outcome measure data.B. The Oklahoma Health Care Authority shall evaluate and report findings to the Governor and the Legislature no later than eighteen (18) months after the start of the program.Added by Laws 2006, c. 315, § 6, emerg. eff. June 9, 2006.
56 OK Stat § 56-1011.7 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.7. Plan to implement alternatives for long-term care.

|The Oklahoma Health Care Authority shall develop and administer a plan for the implementation of alternatives for long-term care. The plan shall include, but not be limited to: |1. The continued development and funding of community-based options throughout the State of Oklahoma;2. The establishment of a cash and counseling program that focuses on increasing personal responsibility, efficiency in utilization, and consumer satisfaction. The program shall include:a.provisions ensuring that existing benefits shall not be terminated or decreased as a result of the development of the cash and counseling program,b.provisions ensuring that consumers receive a monthly budget based on the needs of that individual,c.authority for consumers to use the budget to obtain personal care services and make home modifications to suit the needs of the individual, andd.counselors available to work with consumers to develop and revise individual budgets;3. The establishment of a program providing for state incentives to Oklahoma citizens for long-term care planning; and4. Stronger private/public partnerships at the community level in order to address unmet patient needs.Added by Laws 2006, c. 315, § 7, emerg. eff. June 9, 2006. Amended by Laws 2010, c. 303, § 2, eff. Nov. 1, 2010.
56 OK Stat § 56-1011.8 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.8. Program to encourage use of primary care services in lieu of emergency room services.

|A. The Oklahoma Health Care Authority and the State Department of Health, subject to the availability of funds, may develop and administer a program to encourage the timely and appropriate use of primary care services in lieu of emergency room utilization. The Authority and the Department may collaborate with city-county and county health departments and other relevant stakeholders in the development of the program. The program may include, but not be limited to, the implementation of: |1. Educational strategies to increase health literacy for participants in the Oklahoma Medicaid Program;2. Technology-based monitoring;3. Co-payment structures and other payment arrangements; and4. Other policy proposals to improve the delivery of health care services to Medicaid enrollees.B. The Oklahoma Health Care Authority may develop a pilot program utilizing state-licensed health care professionals to perform educational interventions with consumers who highly utilize emergency room services or to perform other services to reduce unnecessary emergency room visits.C. The Oklahoma Health Care Authority shall develop and implement a telephone information health line pilot program under which physicians are available by telephone twenty-four (24) hours a day to answer medical questions and provide health information for the Medicaid population. If the Health Care Authority determines that the pilot program reduces unnecessary emergency room visits and the pilot program demonstrates a net cost-savings, the Health Care Authority shall expand the program into a statewide initiative.D. The Oklahoma Health Care Authority and the State Department of Health shall evaluate and report findings relevant to the provisions of subsection A of this section to the Governor and the Legislature by January 1, 2019.Added by Laws 2006, c. 315, § 8, emerg. eff. June 9, 2006. Amended by Laws 2017, c. 322, § 1, eff. Nov. 1, 2017.
56 OK Stat § 56-1011.9 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.9. Establishment of method to reduce payment error rate - Reporting of errors.

|A. 1. The Oklahoma Health Care Authority shall establish a method to deter abuse and reduce errors in Medicaid billing, payment, and eligibility through the use of technology and accountability measures for the Authority, providers, and consumers. The Authority shall achieve a payment error rate measurement of no greater than five percent (5%) by fiscal year 2009. The Oklahoma Health Care Authority shall evaluate and report findings to the Governor and the Legislature. |2. For the purposes of this section, “error rate” means errors based on clearly defined objective documentation standards that are readily available to providers. Training to meet the standards shall be provided on at least an annual basis by the Oklahoma Health Care Authority.B. 1. If errors are suspected to be the result of fraudulent acts, the errors shall be reported and investigated by the Oklahoma Attorney General.2. Recoupment of overpayments due to identified errors determined not to be fraudulent and shall occur only after the provider has had the opportunity to exercise the right to an appeal that shall include a hearing conducted by an administrative law judge appointed by the Oklahoma Attorney General. The provider shall have the right to participate in the hearing and to be represented by legal counsel.C. The Oklahoma Health Care Authority shall evaluate and report findings concerning the limited use of the extrapolation method to the Governor and the Legislature.Added by Laws 2006, c. 315, § 9, emerg. eff. June 9, 2006. Amended by Laws 2010, c. 375, § 1, eff. Nov. 1, 2010.
56 OK Stat § 56-1011.10 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.10. Health care benefit waiver for full-time state university or college students.

|The Oklahoma Health Care Authority shall apply for any necessary waiver to extend health care benefits to persons up to the age of twenty-three (23) years if the person is enrolled as a full-time student in an accredited university or college in the State of Oklahoma. |Added by Laws 2006, c. 315, § 10, emerg. eff. June 9, 2006.NOTE: Editorially renumbered from § 1011.10 of Title 63 to provide consistency in numbering.
56 OK Stat § 56-1011.11 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.11. Durable medical equipment retrieval program – Rules - Definition.

|A. The Oklahoma Health Care Authority shall develop and implement, as funds become available, a durable medical equipment retrieval program that will allow the Authority to: |1. Retrieve durable medical equipment, purchased with Medicaid funds, from the Medicaid consumers who no longer utilize the equipment; and2. Donate such equipment to community-based programs that will distribute the equipment to individuals who are disabled or elderly.B. The Oklahoma Health Care Authority Board shall promulgate rules and establish procedures necessary to implement the program established in this section.C. For the purpose of this section, “durable medical equipment” means equipment that is primarily and customarily used to serve a medical purpose, can withstand repeated use and is appropriate for use in the home.Added by Laws 2007, c. 270, § 3, emerg. eff. June 4, 2007. Amended by Laws 2010, c. 309, § 4, eff. Nov. 1, 2010.
56 OK Stat § 56-1011.12 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.12. Feasibility study for state plan amendment for applied behavior analysis treatment of autism spectrum disorder.

|A. The Oklahoma Health Care Authority, in conjunction with the Department of Mental Health and Substance Abuse Services, the State Department of Health and the State Department of Education shall examine the feasibility of a state plan amendment to the Oklahoma Medicaid Program for applied behavior analysis treatment of autism spectrum disorders. |B. On or before December 31, 2016, the Authority and partnering agencies shall submit a report to the President Pro Tempore of the Senate, the Speaker of the House of Representatives and the Governor estimating the potential costs to the state, clinical findings, reviews of pilot projects and research from other states on the effects of applied behavioral analysis treatment on autism spectrum disorders.C. Beginning July 1, 2017, and subject to the availability of funding, the Authority and partnering agencies shall draft a state plan amendment for applied behavior analysis treatment of autism spectrum disorders. The provisions of this subsection shall only apply if the report required by subsection B of this section demonstrates applied behavioral analysis treatment to be evidence-based and essential to qualifying participants in the Oklahoma Medicaid Program.D. As used in this section:1. "Applied behavior analysis" means the design, implementation and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement and functional analysis of the relationship between environment and behavior;2. "Autism spectrum disorder" means any of the pervasive developmental disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the time of diagnosis;3. "Behavioral health treatment" means counseling and treatment programs, including applied behavior analysis, that are:a.necessary to develop, maintain or restore, to the maximum extent practicable, the functioning of an individual, andb.provided by a board-certified behavior analyst or by a licensed doctoral-level psychologist so long as the services performed are commensurate with the psychologist's university training and supervised experience; and4. "Treatment for autism spectrum disorder" means evidence-based care and related equipment prescribed or ordered for an individual diagnosed with an autism spectrum disorder by a licensed physician or a licensed doctoral-level psychologist who determines the care to be medically necessary, including, but not limited to:a.behavioral health treatment,b.pharmacy care,c.psychiatric care,d.psychological care, ande.therapeutic care.Added by Laws 2016, c. 230, § 2, eff. Nov. 1, 2016.
56 OK Stat § 56-1011.13 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.13. Nursing Facility Supplemental Payment Program Revolving Fund.

|A. There is hereby created in the State Treasury a revolving fund for the Oklahoma Health Care Authority to be designated the "Nursing Facility Supplemental Payment Program Revolving Fund". The fund shall be a continuing fund, not subject to fiscal year limitations, and shall consist of: |1. All monies received by the Authority from nonstate governmental organizations pursuant to the Nursing Facility Supplemental Payment Program;2. Any interest or penalties levied and collected in conjunction with the administration of this act; and3. All interest attributable to investment of money in the fund.B. All monies accruing to the credit of the fund are hereby appropriated and may be budgeted and expended by the Authority for the purposes of:1. Transferring funds for the state share of supplemental payments for the Oklahoma Medicaid Program;2. Transferring funds for the state share of administrative expenses incurred by the Authority or its agents and employees in performing the activities authorized by the Nursing Facility Supplemental Payment Program; or3. Transferring funds for the maintenance of nursing facility reimbursement rates; provided, such transfers shall only include funds remaining after the transfers authorized by paragraphs 1 and 2 of this subsection.C. Expenditures from the fund shall be made upon warrants issued by the State Treasurer against claims filed as prescribed by law with the Director of the Office of Management and Enterprise Services for approval and payment.D. Except for the transfers described in subsection B of this section, monies in the Nursing Facility Supplemental Payment Program Revolving Fund shall not be used to replace other general revenues appropriated and funded by the Legislature or other revenues used to support Medicaid.Added by Laws 2017, c. 324, § 1, eff. July 1, 2017.
56 OK Stat § 56-1011.14 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.14. Penalties and interest for failing to timely pay.

|The Oklahoma Health Care Authority shall promulgate administrative rules that govern the assessment of penalties and interest against any nonstate governmental organization that fails to timely pay the full amount of a quarterly intergovernmental transfer; provided, however, that the penalty assessed shall not exceed five percent (5%) of the quarterly amount not paid on or before the due date. Penalties and interest collected pursuant to this section shall be deposited in the Nursing Facility Supplemental Payment Program Revolving Fund, as described in Section 1 of this act. |Added by Laws 2017, c. 324, § 2, eff. July 1, 2017.
56 OK Stat § 56-1011.15 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1011.15. SoonerCare eligibility modifications.

|A. The Oklahoma Health Care Authority (OHCA) shall seek Medicaid waiver authority to pursue modifications to Medicaid eligibility criteria so that receipt of SoonerCare coverage for certain Medicaid populations is conditional upon documentation of certain education, skills, training, work or job activities. Insure Oklahoma eligibility criteria is excluded from this requirement. This requirement is contingent upon approval from the federal Centers for Medicare and Medicaid Services and available state funding. |B. The SoonerCare eligibility modifications provided in subsection A of this section shall include criteria for work or job activities as required for the Supplemental Nutrition Assistance Program (SNAP) in 7 U.S.C., Section 2015(o). In order for an enrollee to remain eligible for SoonerCare, he or she shall comply with the work requirements for SNAP in 7 U.S.C., Section 2015(o). The SoonerCare eligibility criteria work requirements shall be the same as the eligibility criteria work requirements for SNAP in 7 U.S.C., Section 2015(o).C. Exemptions to the eligibility criteria in this section shall be the same as the exemption criteria for SNAP in 7 U.S.C., Section 2015(o)(3)(A), (B), (D) and (E) or Medicaid populations excluded pursuant to federal Medicaid laws and guidelines. Populations excluded from the requirements shall include those which are excluded by SNAP in 7 U.S.C., Section 2015(o)(3)(A), (B), (D) and (E) or federal Medicaid laws and guidelines. The state may adopt additional exemptions subject to agency rule-making and federal approval.Added by Laws 2018, c. 220, § 1, eff. Nov. 1, 2018.
56 OK Stat § 56-1012.1 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1012.1. Short title - Commitment to Care for People with Complex Physical Disabilities Act.

|This act shall be known and may be cited as the "Commitment to Care for People with Complex Physical Disabilities Act". |Added by Laws 2015, c. 324, § 2, eff. Nov. 1, 2015.
56 OK Stat § 56-1012.3 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1012.3. Coverage for specialty provider services.

|A. The Oklahoma Health Care Authority shall take into consideration the unique medical and functional needs of members with complex physical disabilities when preparing or adjusting its budget. |B. The Oklahoma Health Care Authority shall provide coverage for specialty provider services, specialized equipment, and supplies for people with complex physical disabilities. Such coverage shall take into consideration the unique medical and functional needs of people with complex physical disabilities by:1. Identifying a means by which to recognize people with complex physical disabilities through ID codes and/or billing modifiers;2. Determining current procedure terminology billing codes that recognize specialized provider care and preserve a specialized rate which will ensure access to care;3. Identifying criteria required to establish qualifications as a specialty provider; and4. Classifying specialty products and goods into a separate category and establishing a reasonable access protocol for certain items.Added by Laws 2015, c. 324, § 4, eff. Nov. 1, 2015.
56 OK Stat § 56-1012.4 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1012.4. Regulations and policies for CRT products and services.

|The Oklahoma Health Care Authority shall establish focused regulations and policies for CRT products and services. These focused regulations and policies shall take into consideration the customized nature of CRT and the broad range of services necessary to meet the unique medical and functional needs of people with complex physical disabilities by: |1. Designating specific HCPCS billing codes as CRT and, as needed, creating new billing codes or modifiers for services and products covered for people with complex physical disabilities;2. Establishing specific supplier standards for companies or entities that provide CRT and restricting the provision of CRT to only qualified CRT suppliers that meet such standards as defined in Section 3 of this act;3. Requiring complex-needs patients receiving a complex rehabilitation manual wheelchair, power wheelchair, or seating component to be evaluated by:a.a qualified health care professional as defined in Section 3 of this act, andb.a qualified complex rehabilitation technology professional as defined in Section 3 of this act;4. Maintaining payment policies and rates for complex rehabilitation technology to ensure payment amounts are adequate to provide people with complex physical disabilities with access to such items. Such policies and rates shall take into account the significant resources, infrastructure, and staff needed to appropriately provide CRT to meet the unique needs of complex-needs patients;5. Exempting the HCPCS billing codes defined in Section 3 of this act from inclusion in any bidding, selective contracting, or similar such initiative, if the specialty provider service, specialized equipment or supply can only be obtained from a sole source;6. Requiring that Managed Care Medicaid plans adopt the regulations and policies outlined in this act and contract with any willing, qualified CRT supplier; and7. Making other changes as needed to protect access to CRT for complex-needs patients.Added by Laws 2015, c. 324, § 5, eff. Nov. 1, 2015.
56 OK Stat § 56-1015.1 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1015.1. Short title.

|This act shall be known and may be cited as the “Consumer Protection for Wheeled Mobility Act”. |Added by Laws 2008, c. 410, § 1, eff. July 1, 2008.
56 OK Stat § 56-1015.2 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1015.2. Definitions.

|As used in the Consumer Protection for Wheeled Mobility Act: |1. “Assistive technology practitioner” or “ATP” means a for-service provider who is involved in analysis of the needs and training of a consumer in the use of a particular assistive technology device;2. “Assistive technology supplier” or “ATS” means a service provider involved in the sale and service of rehabilitation equipment or commercially available assistive technology products and devices;3. “RESNA” means the Rehabilitation Engineering and Assistive Technology Society of North America; and4. “Specialty evaluation” means the determination and documentation of the consumer’s pathology, history and prognosis, and the physiological, functional, and environmental factors that impact the selection of an appropriate wheeled mobility system.Added by Laws 2008, c. 410, § 2, eff. July 1, 2008.
56 OK Stat § 56-1015.3 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1015.3. Requirements for Medicaid claims on wheeled mobility purchases.

|A. Contingent upon the availability of funding, for Medicaid claims with dates of service on or after April 1, 2009, on all purchased wheeled mobility, the patient shall either have: |1. A specialty evaluation that was performed by a licensed or certified medical professional, such as a physical therapist, occupational therapist, or physician who has specific training and experience in rehabilitation wheelchair evaluations, and that documents the medical necessity for the wheelchair and its special features; or2. The wheelchair provided by a supplier that employs a RESNA-certified assistive technology supplier or assistive technology practitioner who specializes in wheelchairs and who has direct, in-person involvement in the wheelchair selection for the patient; and3. Met the requirements for medical necessity as determined and approved by the Oklahoma Health Care Authority.B. The Oklahoma Health Care Authority shall promulgate rules to implement the Consumer Protection Act for Wheeled Mobility in accordance with the Consumer Protection Act for Wheeled Mobility.Added by Laws 2008, c. 410, § 3, eff. July 1, 2008.
56 OK Stat § 56-1016 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1016. Study of coverage for prosthetic and orthotic devices for Medicaid-eligible individuals.

|A. The Oklahoma Health Care Authority shall study and recommend coverage for prosthetic devices and orthotic devices for Medicaid-eligible individuals. The study shall include the review of payment rates necessary to provide the benefit. The study shall be filed with the Speaker of the House and the President Pro Tempore of the Senate no later than December 31, 2011. |B. As used in this section:1. “Prosthetic device” means an artificial limb device or appliance designed to replace in whole or in part an arm or a leg; and2. "Orthotic device" means a support or brace used to assist weak or ineffective joints or muscles.Added by Laws 2011, c. 334, § 1, eff. Nov. 1, 2011.
56 OK Stat § 56-1017.1 (2021)
2021 Oklahoma Statutes|Title 56. Poor Persons|§56-1017.1. Oklahoma Choices for Long-Term Care Act - Purpose.

|A. Sections 1 through 5 of this act shall be known and may be cited as the “Oklahoma Choices for Long-Term Care Act”. |B. The purpose of the Oklahoma Choices for Long-Term Care Act is to make long-term services and supports for citizens easily accessible, cost-effective and of high quality and to provide a comprehensive and systematic approach to addressing these needs. The Oklahoma Choices for Long-Term Care Act shall provide older Oklahomans and adults with physical disabilities the opportunity to choose where they live and receive their services, and provide efficient administration of the ADvantage Waiver Program.Added by Laws 2011, c. 297, § 1, eff. Sept. 1, 2011.