SUBCHAPTER 1 - Administrative Appeals
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Section 1. Purpose -
Section 2. Appeals -
Section 2.1. Provider appeals and jurisdictional grounds [REVOKED] -
Section 2.2. Recipient appeals [REVOKED] -
Section 2.3. Other grievance procedures and processes [REVOKED] -
Section 2.5. Expedited appeals -
Section 2.6. Continuation of benefits or services pending appeal -
Section 4. Appeal to the Chief Executive Officer [REVOKED] -
Section 5. Hearing procedures -
Section 6. Other grievance procedures and processes [REVOKED] -
Section 7. Program Integrity Audit Appeals -
Section 8. Nursing home provider contract appeals [REVOKED] -
Section 9. OHCA's Designated Agent's appeal process for QIO Decisions -
Section 10. Drug Rebate appeal process -
Section 11. Medicaid Drug Utilization Review Board (DUR) appeal process -
Section 12. For cause and immediate provider contract termination appeals process -
Section 13. Appeal to the chief executive officer -
Section 14. Contract award protest process -
Section 15. Supplemental Hospital Offset Payment Program (SHOPP) Appeals -
Section 16. Nursing Facility Supplemental Payment Program appeals [REVOKED] -
Section 17. Long-term care facility cost report appeals -
Section 18. Step therapy protocol exception appeals
Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.
| Section 1 | Purpose |
| Section 2 | Appeals |
| Section 2.1 | Provider appeals and jurisdictional grounds [REVOKED] |
| Section 2.2 | Recipient appeals [REVOKED] |
| Section 2.3 | Other grievance procedures and processes [REVOKED] |
| Section 2.5 | Expedited appeals |
| Section 2.6 | Continuation of benefits or services pending appeal |
| Section 4 | Appeal to the Chief Executive Officer [REVOKED] |
| Section 5 | Hearing procedures |
| Section 6 | Other grievance procedures and processes [REVOKED] |
| Section 7 | Program Integrity Audit Appeals |
| Section 8 | Nursing home provider contract appeals [REVOKED] |
| Section 9 | OHCA's Designated Agent's appeal process for QIO Decisions |
| Section 10 | Drug Rebate appeal process |
| Section 11 | Medicaid Drug Utilization Review Board (DUR) appeal process |
| Section 12 | For cause and immediate provider contract termination appeals process |
| Section 13 | Appeal to the chief executive officer |
| Section 14 | Contract award protest process |
| Section 15 | Supplemental Hospital Offset Payment Program (SHOPP) Appeals |
| Section 16 | Nursing Facility Supplemental Payment Program appeals [REVOKED] |
| Section 17 | Long-term care facility cost report appeals |
| Section 18 | Step therapy protocol exception appeals |
Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.
