Oklahoma Medicaid Community Engagement Requirements

January 22, 2019

The federal public comment period is closed as of January 19, 2019.

December 20, 2018

The federal public comment period will be open from December 20, 2018 to January 18, 2019. Click here to view submitted public comments.

December 7, 2018

The Oklahoma Health Care Authority (OHCA) submitted the waiver amendment on Friday, Dec. 7, 2018.

October 1, 2018

As of October 1, the Oklahoma Health Care Authority (OHCA) is preparing the amendment to submit to the Centers for Medicare & Medicaid Services (CMS).

View the handout with more information on this amendment!

Background

With the announcement from the current federal administration to support innovative approaches to increase employment and community engagement, Oklahoma began exploring strategies that would allow the state to take advantage of flexibilities in the Medicaid program that are designed to improve health outcomes and promote personal responsibility. A workgroup was convened in 2017 by the Governor to examine the effects and barriers of community engagement requirements as a condition of Medicaid eligibility.Additionally, the workgroup was to assess the most effective way to engage individuals receiving public assistance in the state to take an active role in their communities through employment, education, and training activities resulting in skills needed for long-term independence, success, better health, and well-being. The correlation between employment and health for the general population is well established and presented in several large-scale literature reviews and meta-analyses.

As a result of the workgroup’s findings, on March 5, 2018, the Governor of Oklahoma signed an executive order directing the OHCA to apply for waiver and state plan amendments that would allow the State to implement community engagement requirements in the state Medicaid program.In addition to the executive order, HB 2932 was passed by the state legislature, in the Oklahoma 56^th Second Legislature Session, and signed into law by Governor Mary Fallin.HB 2932 directs OHCA to pursue modifications to Medicaid eligibility criteria so that recipients of SoonerCare coverage for certain Medicaid populations are conditional upon documentation of certain education, skills training, community engagement, or job activities.

The OHCA submitted the community engagement waiver amendment to the Centers for Medicare & Medicaid Services (CMS) on Dec. 7, 2018. The federal public comment period will be open until Jan.18, 2019, at Medicaid.gov.

Upon approval from CMS, the state of Oklahoma will implement community engagement requirements for certain individuals related to SoonerCare (Oklahoma Medicaid) eligibility. As a condition of eligibility for SoonerCare benefits, applicants or existing members, not otherwise exempted, age 19-50 must provide verification of employment or community engagement in specified educational, job training or job search activities for an average of 80 hours per month. SoonerCare members who fail to meet the community engagement requirements for three months during a plan year will be disenrolled from SoonerCare until requirements are met. There is a three-month grace period before members are required to provide proof of community engagement; however, the member could also have a good cause exception.

Qualifying Community Engagement, Educational, Job Training or Job Search Activities

SoonerCare community engagement activities are modeled in accordance with the Supplemental Nutrition Assistance Program (SNAP) currently operational in Oklahoma.Community engagement requirements for new or continued SoonerCare eligibility can be found on the Policy Change Blog.

Exemptions

Certain individuals may be exempted from the above requirements. For a complete list of individuals who are exempt from the SoonerCare community engagement requirements please refer to the Policy Change Blog website.

Timeline

Upon approval from CMS, the state of Oklahoma will implement community engagement requirements for certain individuals related to SoonerCare (Oklahoma Medicaid) eligibility.

Public Meetings

As of today's date, the agency has scheduled the below required public meetings. Information on additional meetings will be provided as future dates and times are determined.

July 11, 2018
11 a.m.
Tribal Consultation
Charles Ed McFall Boardroom
Oklahoma Health Care Authority
4345 N. Lincoln Blvd, Oklahoma City, OK

July 19, 2018
1 p.m.
Medical Advisory Committee
Charles Ed McFall Boardroom
Oklahoma Health Care Authority
4345 N. Lincoln Blvd, Oklahoma City, OK

August 10, 2018
11:30 a.m. - 12 p.m.
OU Sooner Health Access Network
OU – Tulsa Schusterman Center – Learning Center
4502 E. 41^st Street, Tulsa, OK

The following meetings are open to the public and do not require registration.

August 16, 2018
3 p.m.
Comanche County Health Department
1010 SW Sheridan Rd., Lawton, OK

August 17, 2018
3 p.m.
Norman Regional - Porter Campus
Education Center, Rooms ABC
901 N. Porter Ave., Norman, OK

August 20, 2018
1:30 p.m.
Pawnee City Hall
510 Illinois St., Pawnee, OK

August 21, 2018
1:30 p.m.
Variety Care - Lafayette Clinic
500 SW 44th St., Oklahoma City, OK

August 23, 2018
3 p.m.
Northwestern Oklahoma State University
Room 131
2929 E. Randolph Ave., Enid, OK

August 24, 2018
10 a.m.
Eastern Oklahoma State College - McAlester Campus
1802 College Ave., McAlester, OK

August 24, 2018
2 p.m.
Kiamichi Technology Center - Poteau Campus
1509 S. McKenna St., Poteau, OK

August 27, 2018
3 p.m.
James O. Goodwin Health Center
5051 S. 129th E. Ave, Tulsa, OK

September 20, 2018
1 p.m.
Medical Advisory Committee
Charles Ed McFall Boardroom
Oklahoma Health Care Authority
4345 N. Lincoln Blvd., Oklahoma City, OK

Oklahoma Medicaid Community Engagement Requirements

Updates

Background

resources