reglab/statecodes huggingface dataset:
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 5 - DETERMINATION OF ELIGIBILITY FOR MEDICAL SERVICES › Section 317:35-7-46 - Eligibility as Qualifying Individuals

Current through Vol. 41, No. 20, July 1, 2024
An individual determined to be categorically related as
					 aged, blind or disabled is eligible as a Qualifying Individual (QI) if he/she
					 meets the conditions of eligibility in paragraphs (1), (2), and (3) of this
					 Section.
(1) The individual is
				  enrolled for Medicare hospital insurance benefits under Part A, which includes
				  an individual entitled to hospital insurance benefits by reason of voluntary
				  enrollment in the premium-paying Part A program.
(2) The individual's income and resources do
				  not exceed the standard as shown on DHS Appendix C-1, Schedule VII.A for QI-1.
				  The maximum income standard for the QI-1 program is an amount greater than 120%
				  but less than 135% of the Federal Poverty Level. For an individual whose spouse
				  is not eligible for Medicare, total countable income of the eligible individual
				  must be equal to or less than the QI standards for an individual and the income
				  of both must be equal to or less than the QI standards for a couple. For a
				  couple who are both eligible for Medicare, total countable income must be equal
				  to or less than the QI standards for a couple. Countable income and resources
				  are determined using the same rules followed in determining eligibility for
				  individuals categorically related to Aid to the Aged, Blind or Disabled, with
				  the following exceptions:
(A) Payments from
				  Champus for medical care or from VA for Aid and Attendance are not considered
				  in determining income eligibility.
(B) A $20 general income disregard is also
				  applied to either earned or unearned income, but not both. For couples, only
				  one $20 general income disregard is given.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 5 - DETERMINATION OF ELIGIBILITY FOR MEDICAL SERVICES › Section 317:35-7-48 - Eligibility for the SoonerPlan Family Planning Program

Current through Vol. 41, No. 20, July 1, 2024
(a) Non-pregnant women and men ages 19 and
				  above are eligible to receive family planning services if they meet all of the
				  conditions of eligibility in paragraphs (1), (2), (3), and (4) of this
				  Subsection. This is regardless of pregnancy or paternity history and includes
				  women who gain eligibility for Sooner-Care family planning services due to a
				  pregnancy, but whose eligibility ends 60 days postpartum.
(1) MAGI financial eligibility rules are used
				  to determine eligibility for Sooner-Plan.
(2) MAGI household composition rules are used
				  to determine eligibility for SoonerPlan.
(3) SoonerPlan members with minor dependent
				  children and a parent absent from the home are required to cooperate with the
				  Oklahoma Department of Human Services, Child Support Services Division (OCSS)
				  in the collection of child support payments. Federal regulations provide a
				  waiver of this requirement when cooperation is not in the best interest of the
				  child.
(4) Individuals eligible for
				  SoonerCare can choose to enroll only in the SoonerPlan Family Planning Program
				  with the option of applying for SoonerCare at any time.
(5) Persons who have Medicare or creditable
				  health insurance coverage are not precluded from applying for the SoonerPlan
				  Family Planning program.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-60 - Certification for SoonerCare

Current through Vol. 41, No. 20, July 1, 2024
(a)
General.
The rules in this Section apply to the following
				  categories of eligibles:
(1) Categorically
				  needy SoonerCare members who are categorically related to Aged, Blind, and
				  Disabled (ABD);
(2) Categorically
				  needy SoonerCare members who are categorically related to ABD, and are eligible
				  for one of the following:
(A) Qualified
				  Medicare Beneficiary Plus (QMBP);
(B) Qualified Disabled and Working Individual
				  (QDWI);
(C) Specified Low-Income
				  Medicare Beneficiary (SLMB);
(D)
				  Tuberculosis (TB) related services;
(E) Qualifying Individual (QI); or
(F) Tax Equity and Fiscal Responsibility Act
				  (TEFRA).
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-60.1 - Certification for the SoonerPlan Family Planning Program

Current through Vol. 41, No. 20, July 1, 2024
The effective date of certification for the SoonerPlan
					 Family Planning Program is the date of application or later. The period of
					 certification may not be for a retroactive period. An individual determined
					 eligible for the SoonerPlan Family Planning Program is assigned a certification
					 period of 12 months. At any time during the certification period the individual
					 becomes ineligible, the case is closed using standard negative action
					 procedures. At the end of the certification period, a redetermination of
					 eligibility is required.
Added at 22 Ok Reg 1012, eff 4-1-05 (emergency) ; Added
						at 22 Ok Reg 2518, eff 7-11-05 ; Amended at 27 Ok Reg 711, eff 2-4-10
						(emergency) ; Amended at 27 Ok Reg 1471, eff 6-11-10 ; Amended at 29 Ok Reg
						1149, eff 6-25-12 ; Amended at 30 Ok Reg 1209, eff
						7-1-13
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-61 - Redetermination of eligibility for persons receiving ABD or TANF

Current through Vol. 41, No. 20, July 1, 2024
A periodic redetermination of eligibility for Medical
					 Services is required every twelve months on all categorically needy cases which
					 also receive a money payment, QMBP, SLMB, QI-1, QDWI, or
					 TEFRA.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 16 Ok Reg 708, eff 1-1-99 (emergency); Amended at 16 Ok Reg
					 1438, eff 5-27-99; Amended at 18 Ok Reg 114, eff 11-1-00 (emergency); Amended
					 at 18 Ok Reg 1139, eff 5-11-01; Amended at 22 Ok Reg 2494, eff
					 7-11-05
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-61.1 - Special redetermination procedures for Tax Equity and Fiscal Responsibility Act (TEFRA)

Current through Vol. 41, No. 20, July 1, 2024
In addition to redetermining the level of care, the OHCA also conducts an annual cost effectiveness review for all active TEFRA children. If OHCA determines the child does not meet any level of care, is no longer disabled, or the estimated cost of care in the home is greater than the estimated cost of care in an institution, at the appropriate level of care, the case is closed.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-61.1 - Special redetermination procedures for Tax Equity and Fiscal Responsibility Act (TEFRA)

Current through Vol. 41, No. 20, July 1, 2024
In addition to redetermining the level of care annually,
					 the OHCA also conducts an annual cost effectiveness review for all active TEFRA
					 children. If OHCA determines the child does not meet any level of care, is no
					 longer disabled, or the estimated cost of care in the home is greater than the
					 estimated cost of care in an institution, at the appropriate level of care, the
					 case is closed.
Added at 22 Ok Reg
					 2494, eff 7-11-05
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-62 - Special redetermination procedures for children in custody or subsidized adoptions

Current through Vol. 41, No. 20, July 1, 2024
A periodic redetermination of eligibility for Medical
					 Services is required every twelve months for children in custody or subsidized
					 adoptions as reported by DHS.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 20 Ok Reg 2797, eff 5-26-03 (emergency); Amended at 21 Ok
					 Reg 2235, eff 6-25-04
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-63 - Notification of eligibility [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95
						(emergency) ; Added at 12 Ok Reg 3133, eff 7-27-95 ; Amended at 14 Ok Reg 56,
						eff 4-30-96 (emergency) ; Amended at 14 Ok Reg 1802, eff 5-27-97 ; Amended at
						27 Ok Reg 711, eff 2-4-10 (emergency) ; Amended at 27 Ok Reg 1471, eff 6-11-10
						; Revoked at 30 Ok Reg 1209, eff 7-1-13
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-64 - Denials [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95
						(emergency) ; Added at 12 Ok Reg 3133, eff 7-27-95 ; Amended at 20 Ok Reg 2775,
						eff 7-1-03 (emergency) ; Amended at 21 Ok Reg 2234, eff 6-25-04 ; Amended at 27
						Ok Reg 711, eff 2-4-10 (emergency) ; Amended at 27 Ok Reg 1471, eff 6-11-10 ;
						Revoked at 30 Ok Reg 1209, eff 7-1-13
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-65 - Closures [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95
						(emergency) ; Added at 12 Ok Reg 3133, eff 7-27-95 ; Amended at 27 Ok Reg 711,
						eff 2-4-10 (emergency) ; Amended at 27 Ok Reg 1471, eff 6-11-10 ; Revoked at 30
						Ok Reg 1209, eff 7-1-13
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 7 - Medical Services › Part 7 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-7-66 - Transfer of case records between counties [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95
						(emergency) ; Added at 12 Ok Reg 3133, eff 7-27-95 ; Revoked at 30 Ok Reg 1209,
						eff 7-1-13
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-1 - Overview of long-term medical care services; relationship to QMB, SLMB, and other Medicaid services eligibility, and spenddown calculation

Current through Vol. 41, No. 20, July 1, 2024
(a)
Long Term
				  Medical Care Services.
Long-term medical care for the categorically
				  needy includes care in a nursing facility (refer to OAC 317:35-19), public and
				  private intermediate care facility for the mentally retarded (refer to this
				  subchapter), persons age 65 years or older in mental health hospitals (refer to
				  this subchapter), Home and Community Based Waiver Services for the
				  Intellectually Disabled (refer to this subchapter), and Home and Community
				  Based Waiver Services for frail elderly and a targeted group of adults with
				  physical disabilities age 21 and over who have not been determined to have a
				  developmental disability, an intellectual disability or a related condition
				  (refer to OAC 317:35-17). Personal Care provides services in the own home for
				  categorically needy individuals (refer to OAC 317:35-15). Any time an
				  individual is certified as eligible for Medicaid coverage of long-term care,
				  the individual is also eligible for other Medicaid services. Another
				  application or additional spenddown computation is not required. Spenddown is
				  applied to the first long-term care claim filed. Any time an aged, blind or
				  disabled individual is determined eligible for long-term care, a separate
				  determination must be made to see if eligibility conditions as a Qualified
				  Medicare Beneficiary (QMB) or Specified Low-Income Medicare Beneficiary (SLMB)
				  are met. Another application for QMB or SLMB benefits is not required. Any
				  spenddown computed for long-term care is not applicable to QMB or SLMB
				  coverage.
(b)
Medicaid
				  recovery.
The State of Oklahoma operates a Medicaid Recovery program to
				  recover for services identified in OAC
				  317:35-9-15.
				  Recovery can be accomplished in two ways: liens against real property or claims
				  made against estates.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 20 Ok Reg
					 2775, eff 7-1-03 (emergency); Amended at 21 Ok Reg 2234, eff 6-25-04; Amended
					 at 29 Ok Reg 1162, eff 6-25-12
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-2 - Services in a Nursing Facility (NF) [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Revoked at 17 Ok Reg 2410, eff 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-3 - ADvantage program services [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Amended at 14 Ok Reg
					 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg 1802, eff 5-27-97; Revoked at
					 17 Ok Reg 2410, eff 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-4 - Services in Intermediate Care Facility for Individuals with Intellectual Disabilities (public and private)

Current through Vol. 41, No. 20, July 1, 2024
(a)
				  Services in a private Intermediate Care Facility for Individuals with
				  Intellectual Disabilities (ICF/IID) may be provided to members requiring health
				  or habilitative services above the level of room and board. Services are
				  provided to members who meet level of care and eligibility requirements per OAC
				  317:30-5-122 and
				  317:35-9-45.
(b) Services in a public ICF/IID
				  may be provided to members who require health or habilitative services above
				  the level of room and board. Services are provided to members who meet level of
				  care requirements per OAC
				  317:30-5-122.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 28 Ok Reg
					 1534, eff 6-25-11
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-5.1 - Home and Community Based Waiver Services for individuals with mental retardation and related conditions [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 14 Ok Reg 56,
					 eff 4-30-96 (emergency); Added at 14 Ok Reg 1802, eff 5-27-97; Amended at 17 Ok
					 Reg 2410, eff 6-26-00; Revoked at 28 Ok Reg 1534, eff
					 6-25-11
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-6 - Non-Technical Medical Care in own home [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 (emergency); Added at 12 Ok Reg 1935, eff 5-22-95 (emergency);
					 Added at 13 Ok Reg 2537, eff 6-27-96; Revoked at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 1 - SERVICES › Section 317:35-9-7 - Services for persons age 65 or older in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
Services for persons age 65 years or older in mental health
					 hospitals are mental health services provided in an inpatient hospital setting
					 to eligible categorically needy individuals whose condition cannot adequately
					 be treated on an outpatient basis. These individuals are not eligible for the
					 Qualified Medicare Beneficiary program (QMB) or the Specified Low-Income
					 Medicare Beneficiary program (SLMB).
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 2 - MEDICAID RECOVERY PROGRAM › Section 317:35-9-15 - Medicaid recovery

Current through Vol. 41, No. 20, July 1, 2024
(a)
General
				  overview.
The Omnibus Budget Reconciliation Act of 1993 mandates the
				  State to seek recovery against the estate of certain Title XIX members who
				  received medical care on or after July 1, 1994, and who were 55 years of age or
				  older when the care was received. The payment of Title XIX by the Oklahoma
				  Health Care Authority (OHCA) on behalf of a member who is an inpatient of a
				  nursing facility, intermediate care facility for the mentally retarded or other
				  medical institution creates a debt to the OHCA subject to recovery by legal
				  action either in the form of a lien filed against the real property of the
				  member and/or a claim made against the estate of the member. Only Title XIX
				  received on or after July 1, 1994, will be subject to provisions of this Part.
				  Recovery for payments made under Title XIX for nursing care is limited by
				  several factors, including the family composition at the time the lien is
				  imposed and/or at the time of the member's death and by the creation of undue
				  hardship at the time the lien is imposed or the claim is made against the
				  estate. [See OAC
				  317:35-5-41.8(a)(3)(H)
				  for consideration of home property as a countable resource.] State Supplemental
				  Payments are not considered when determining the countable income. The types of
				  medical care for which recovery can be sought include:
(1) nursing facility services;
(2) home and community based
				  services;
(3) related hospital
				  services;
(4) prescription drug
				  services;
(5) physician services;
				  and
(6) transportation
				  services.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-25 - Application for ICF/MR, HCBW/ID, and persons aged 65 or over in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
(a)
Application procedures for long-term medical care.
An application
				  for these types of services consists of the Medical Assistance Application. The
				  Medical Assistance Application is signed by the patient, parent, spouse,
				  guardian or someone else acting on the patient's behalf.
(1) All conditions of eligibility must be
				  verified and documented in the case record. When current information already
				  available in the local office establishes eligibility, such information may be
				  used by recording source and date of information. If the applicant also wishes
				  to apply for a State Supplemental Payment, either the applicant or his/her
				  guardian must sign the application form.
(2) At the request of an individual in an
				  ICF/MR or receiving Home and Community Based Waiver Services for the
				  Intellectually Disabled or the community spouse, if application for Medicaid is
				  not being made, an assessment of the resources available to each spouse is made
				  by use of DHS Form MA-11, Assessment of Assets. Documentation of resources must
				  be provided by the individual and/or spouse. This assessment reflects all
				  countable resources of the couple (owned individually or as a couple) and
				  establishes the spousal share to be protected when subsequent determination of
				  Medicaid eligibility is made. A copy of Form MA-11 is provided to each spouse
				  for planning in regard to future eligibility. A copy is retained in the county
				  office in case of subsequent application.
(3) If assessment by Form MA-11 was not done
				  at the time of entry into the ICF/MR or HCBW/ID services, assessment by use of
				  Form MA-11 must be done at the time of application for Medicaid. The spousal
				  share of resources is determined in either instance for the month of entry into
				  the ICF/MR or HCBW/ID services. If the individual applies for Medicaid at the
				  time of entry into the ICF/MR or HCBW/ID services, Form MA-11 is not
				  appropriate. However, the spousal share must be determined using the resource
				  information provided on the Medicaid application form and computed using DHS
				  Form MA-12, Title XIX Worksheet.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-26 - Application procedures for private ICF/MR

Current through Vol. 41, No. 20, July 1, 2024
Individuals may apply for private ICF/MR at the OKDHS human
					 services center (HSC) of their choice. A written application is not required
					 for an individual who has an active SoonerCare case. The OKDHS Notification
					 Regarding Patient in a Nursing Facility, Intermediate Care Facility for the
					 Mentally Retarded or Hospice form 08MA083E, when received in the HSC, also
					 constitutes an application request and is handled the same as an oral request.
					 The local HSC will send the ICF/MR OKDHS form 08MA038E within three working
					 days of receipt of OKDHS forms 08MA083E and 08MA084E, Management of Recipient's
					 Funds, indicating actions that are needed or have been taken regarding the
					 member.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 26 Ok Reg
					 408, eff 1-1-09 (emergency); Amended at 26 Ok Reg 2139, eff
					 6-25-09
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-27 - Application procedures for public ICF/MR

Current through Vol. 41, No. 20, July 1, 2024
When an individual is admitted to a public ICF/MR, an
					 application for payment of long-term care in the facility is made at the time
					 of admission. A designated worker from the county office in the county where
					 the facility is located assists in this part of the admission process. The
					 superintendent of the facility may sign the application on behalf of the
					 individual if the responsible parent or guardian is not available. A case
					 record is set up, in the county where the facility is located, for each
					 applicant of the public ICF/MR. If the individual leaves the facility, the
					 county case is transferred, if necessary, to the county of
					 residence.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 7-27-97; Amended at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-28 - Application procedures for services provided by Developmental Disability Services Division (DDSD)

Current through Vol. 41, No. 20, July 1, 2024
(a)
Application.
The county office is responsible for taking a new
				  application for Medicaid if an active case is not already in existence. The
				  worker must determine if the individual would be financially eligible for
				  Medicaid benefits as categorically needy according to DHS Appendix C-1,
				  Schedule VIII. B.
(1) When DHS/DDSD resources
				  are sufficient for initiation of HCBW services, the DDSD case manager notifies
				  the DHS county office of the request by DHS form K-13. The application date is
				  the date Form K-13 is received in the county office.
(2) When a request for HCBW originates in the
				  county office, the DHS social worker refers the applicant to the DHS/DDSD Area
				  Office for completion of DHS form DDS-1, Application for Developmental
				  Disabilities Services.
(3) The
				  DHS/DDSD case manager determines whether or not a categorical relationship
				  decision is necessary.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-29 - Application procedures for persons age 65 or older in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
Under contracts between the OHCA and mental health
					 hospitals, Medicaid applications for payment of care on behalf of individuals
					 65 years of age or older may be completed by the mental health hospital staff
					 on behalf of these persons.
(1) An
				  application for payment of care is made only on those patients age 65 years of
				  age or older who are not eligible for (or who have exhausted) benefits under
				  Title XVIII, Part A (Medicare, Part A), for the type of medical services for
				  which they are now requesting payment under Medicaid. The completed application
				  forms are forwarded to the local DHS office. A statement that the patient is
				  not eligible under Medicare for the type of care for which payment is being
				  requested must be attached.
(2)
				  When there is a spouse who is not a patient in the mental health hospital or
				  there is a guardian, the spouse or guardian's name and address is shown on the
				  application form in addition to the patient's name in order that notifications
				  are sent to the responsible person.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 3 - APPLICATION PROCEDURES › Section 317:35-9-30 - Special application procedures for children in DHS custody [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Revoked at 17 Ok Reg 2410, eff 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-45 - Determination of medical eligibility for care in a private Intermediate Care Facility for Individuals with Intellectual Disabilities(ICF/IID)

Current through Vol. 41, No. 20, July 1, 2024
(a)
Pre-approval of medical eligibility.
Pre-approval of medical
				  eligibility for private ICF/IIDcare is based on level of care requirements per
				  OAC
				  317:30-5-122.
				  Pre-approval is not necessary for individuals with a severe or profound
				  intellectual disability. Pre-approval is made by Oklahoma Health Care Authority
				  (OHCA) Level of Care Evaluation Unit (LOCEU) analysts.
(b)
Application for ICF/IID
services. Within 30 calendar days after services begin, the facility must
				  submit:
(1) The original of the ICF/IID Level
				  of Care Assessment form (LTC-300) to LOCEU. Required attachments include:
(A) Current (within 90 days of requested
				  approval date) medical information signed by a physician.
(B) A current (within 12 months of requested
				  approval date) psychological evaluation by a licensed Psychologist or State
				  staff supervised by a licensed Psychologist. The evaluation must include
				  intelligence testing that yields a full-scale intelligence quotient, a
				  full-scale functional or adaptive assessment, as well as the age of onset.
(C) A copy of the pertinent
				  section of the Individual Plan or other appropriate documentation relative to
				  the ICF/IID admission and the need for ICF/IID level of care.
(D) A statement that the member is not an
				  imminent threat of harm to self or others (i.e., suicidal or homicidal).
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-45.1 - Determination of medical eligibility for Non-Technical Medical Care [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 1935, eff 5-22-95 (emergency); Added at 14 Ok Reg 56, eff 4-30-96 (emergency);
					 Added at 13 Ok Reg 2537, eff 6-27-96; Amended at 14 Ok Reg 1802, eff 5-27-97;
					 Revoked at 17 Ok Reg 2410, eff 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-46 - Determination of continued medical eligibility for care in NF and private ICF/MR [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Revoked at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-47 - Determination of continued medical eligibility for NTMC [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 (emergency); Added at 12 Ok Reg 1935, eff 5-22-95 (emergency);
					 Added at 14 Ok Reg 56, eff 4-30-96 (emergency); Added at 13 Ok Reg 2537, eff
					 6-27-96; Amended at 14 Ok Reg 1802, eff 5-27-97; Revoked at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-48.1 - Determining ICF/IID institutional level of care for TEFRA children

Current through Vol. 41, No. 20, July 1, 2024
In order to determine Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care for Tax Equity and Fiscal Responsibility Act (TEFRA) children:
(1) The child must be age eighteen (18) years or younger and expected to meet the following criteria for at least thirty (30) days.
(A) Applicants under age three (3) must:
(i) Have a diagnosis of a developmental disability; and
(ii) Have been evaluated by the SoonerStart Early Intervention Program or other appropriate healthcare provider, and found to have severe functional deficiencies with findings of at least two (2) standard deviations in at least two (2) total domain areas.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-48.1 - Determining ICF/IID institutional level of care for TEFRA children

Current through Vol. 41, No. 20, July 1, 2024
In order to determine ICF/IID level of care for TEFRA
					 children:
(1) The child must be age 18
				  years or younger and expected to meet the following criteria for at least 30
				  days.
(A) Applicants under age three must:
(i) have a diagnosis of a developmental
				  disability; and
(ii) have been
				  evaluated by the SoonerStart Early Intervention Program or other appropriate
				  healthcare provider, and found to have severe dysfunctional deficiencies with
				  findings of at least two standard deviations in at least two total domain
				  areas.
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-49 - Determination of medical eligibility for Home and Community Based Waiver Services for the Intellectually Disabled

Current through Vol. 41, No. 20, July 1, 2024
Determinations of medical eligibility for Home and
					 Community Based Waiver Services for the Intellectually Disabled (HCBW/ID) is
					 made through referral to the DHS DDSD case manager.
(1)
Referral.
If the county
				  receives an application, Form K-13 is forwarded to the DDSD case manager, who
				  is responsible for securing a HCBW/ID medical determination and a disability
				  decision, if needed.
(2)
Initial request.
If the initial request is through DDSD, Form K-13
				  is forwarded to the county for completing the application process.
(3)
Plan of care packet.
The
				  DDSD case manager submits the necessary information to LOCEU for medical
				  determination and a disability decision if needed.
(4)
County notification.
LOCEU
				  notifies the county and DDSD case manager of determination by updating the
				  MEDATS file.
(5)
Procedures
				  for an individual returning home.
If referral is from a public ICF/MR
				  for an individual returning to the home, the DDSD case manager forwards to the
				  worker the medical eligibility determination for HCBW/ID along with the latest
				  application form and redetermination of eligibility form used to determine
				  eligibility for institutional care. A new application will not be required. A
				  case number will be assigned retaining the application date, certification date
				  and redetermination of eligibility date.
(6)
Determination of continued
				  eligibility for HCBW/ID.
The case manager is responsible for assuring
				  that the individual's needs are re-evaluated and that recertification is
				  established annually. Determination of continued medical eligibility is not
				  necessary unless there is a significant change in the client's condition. The
				  DDSD cases manager will notify LOCEU if this is the case.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 29 Ok Reg
					 1162, eff 6-25-12
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-50 - Determination of medical eligibility for persons age 65 or older in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
Medical eligibility is determined based on residence in a
					 mental health hospital due to the need for care and treatment provided under
					 the direction of a physician in an institution for mental diseases. Visits are
					 made to the mental health hospital by OHCA staff. Patients' charts are reviewed
					 to determine if continued institutional care is appropriate and the medical
					 records are maintained in accordance with federal regulations. A worksheet is
					 completed on each case showing the findings of the reviews. The worksheets are
					 maintained in the OHCA.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-51 - Change in level of long-term medical care [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 (emergency); Added at 12 Ok Reg 1935, eff 5-22-95 (emergency);
					 Added at 14 Ok Reg 56, eff 4-30-96 (emergency); Added at 13 Ok Reg 2537, eff
					 6-27-96; Amended at 14 Ok Reg 1802, eff 5-27-97; Revoked at 17 Ok Reg 2410, eff
					 6-26-00
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 5 - DETERMINATION OF MEDICAL ELIGIBILITY FOR ICF/IID, HCBW/IID, AND INDIVIDUALS AGE 65 OR OLDER IN MENTAL HEALTH HOSPITALS › Section 317:35-9-52 - Determination of medical eligibility for the ADvantage waiver [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Revoked at 14 Ok Reg 56, eff 4-30-96 (emergency); Revoked at 14 Ok Reg
					 1802, eff 5-27-97
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 7 - DETERMINATION OF FINANCIAL ELIGIBILITY › Section 317:35-9-65 - General financial eligibility requirements for ICF/MR, HCBW/MR, and individuals age 65 or older in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
Financial eligibility for these types of long-term medical
					 care is determined using the rules on income and resources according to OAC
					 317:35-7-36.
(1) Income, resources and expenses are
				  evaluated on a monthly basis for all individuals requesting payment for
				  long-term medical care.
(2) To be
				  eligible for long-term care in an ICF/MR (private and public), HCBW/MR services
				  and for persons 65 years or older in mental health hospitals, the individual
				  must be determined categorically needy.
(3) If the individual's gross income exceeds
				  the categorically needy standard as shown on OKDHS Form 08AX001E, Schedule
				  VIII. B. 1., refer to OAC
				  317:35-5-41.6(a)(6)(B)
				  for rules on establishing a Medicaid Income Pension Trust.
(4) When eligibility for long-term care has
				  been determined, the vendor payment amount, if applicable, is determined based
				  on type of care, community spouse, etc. Individuals determined eligible for
				  HCBW/MR services will not have a vendor payment.
(5) The vendor payment is applied to the
				  first claim(s) received on behalf of the individual.
(6) For an individual eligible for long-term
				  care in an ICF/MR (private and public) or for an individual 65 years or older
				  in a mental health hospital, the vendor payment is not prorated over the month.
				  As SoonerCare is the payer of last resort, the full amount of the vendor
				  payment must first be applied to the facility's charges before SoonerCare
				  reimbursement begins.
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Amended at 14 Ok Reg 56, eff 4-30-96 (emergency); Amended at 14 Ok Reg
					 1802, eff 5-27-97; Amended at 17 Ok Reg 2410, eff 6-26-00; Amended at 19 Ok Reg
					 76, eff 9-20-01 (emergency); Amended at 19 Ok Reg 1071, eff 5-13-02; Amended at
					 25 Ok Reg 130, eff 8-1-07 (emergency); Amended at 25 Ok Reg 1257, eff 5-25-08;
					 Amended at 26 Ok Reg 2132, eff 6-25-09
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 7 - DETERMINATION OF FINANCIAL ELIGIBILITY › Section 317:35-9-66 - Determining financial eligibility for ADvantage waiver [REVOKED]

Current through Vol. 41, No. 20, July 1, 2024
Added at 12 Ok Reg
					 753, eff 1-6-95 through 7-14-95 (emergency); Added at 12 Ok Reg 3133, eff
					 7-27-95; Revoked at 14 Ok Reg 56, eff 4-30-96 (emergency); Revoked at 14 Ok Reg
					 1802, eff 5-27-97
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 7 - DETERMINATION OF FINANCIAL ELIGIBILITY › Section 317:35-9-68 - Determining financial eligibility for care in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) (public and private), for HCBW/IID services, and for persons age sixty-five (65) or older in mental health hospitals

Current through Vol. 41, No. 20, July 1, 2024
(a)
Determining financial eligibility for care in an ICF/IID .
Financial eligibility and spenddown for individuals in an ICF/IID is determined
				  according to whether or not a spouse remains in the home.
(1)
Individual without a spouse.
For an individual without a spouse, the following rules are used to determine
				  financial eligibility for ICF/IID care.
(A)
Income eligibility.
To determine the income of the individual
				  without a spouse, the rules in (i) - (iii) of this subparagraph apply.
(i) If payment of income is made to the
				  individual and another person(s), the income is considered in proportion to the
				  individual's interest.
(ii) If a
				  legal instrument exists which specifies terms of payment, income is considered
				  according to the terms of the instrument.
(iii) After determination of income, the
				  gross income of the individual cannot exceed the categorically needy standard
				  in Oklahoma Department of Human Services (OKDHS) Form 08AX001E (Appendix C-1),
				  Schedule VIII. B. 1., to be eligible for ICF/IID services. If the individual's
				  gross income exceeds this standard, refer to SoonerCare rules for establishing
				  a Medicaid Income Pension Trust [OAC
				  317:35-5-41.6(a)(6)(B)
				  ].
Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 35 - Medical Assistance for Adults and Children-Eligibility › Subchapter 9 - Icf/Iid, Hcbw/Iid, and Individuals Age 65 or Older in Mental Health Hospitals › Part 9 - CERTIFICATION, REDETERMINATION AND NOTIFICATION › Section 317:35-9-75 - Certification for long-term medical care through ICF/IID, HCBW/IID services and to persons age 65 and older in a mental health hospital

Current through Vol. 41, No. 20, July 1, 2024
(a)
Application date.
If the applicant is found eligible for
				  SoonerCare, certification may be made retroactive for any service provided on
				  or after the first day of the third month prior to the month of application and
				  for future months. The first month of the certification period must be the
				  first month that medical service was provided and the recipient was determined
				  eligible.
(b)
Certification
				  period for long-term medical care.
A certification period of twelve (12)
				  months is assigned for an individual who is approved for long-term
				  care.
Added at 12 Ok Reg 753, eff 1-6-95 through 7-14-95
						(emergency) ; Added at 12 Ok Reg 3133, eff 7-27-95 ; Amended at 14 Ok Reg 56,
						eff 4-30-96 (emergency) ; Amended at 14 Ok Reg 1802, eff 5-27-97 ; Amended at
						17 Ok Reg 2410, eff 6-26-00 ; Amended at 23 Ok Reg 268, eff 9-1-05 (emergency)
						; Amended at 23 Ok Reg 1378, eff 5-25-06 ; Amended at 30 Ok Reg 1209, eff
						7-1-13