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OHCA Policies and Rules

 

Section 1 Overview of long-term medical care services; relationship to Qualified Medicare Beneficiary Plus (QMBP), Specified Low-Income Medicare Beneficiary (SLMB), and other Medicaid (SoonerCare) services eligibility
Section 2 Level of care medical eligibility determination
Section 3 ADvantage program services
Section 4 Application for ADvantage services
Section 5 ADvantage program medical eligibility determination
Section 6 Pre-admission screening [REVOKED]
Section 7 PASRR screening process [REVOKED]
Section 8.1 PASRR appeals process [REVOKED]
Section 9 General financial eligibility requirements for the ADvantage program
Section 10 Determining financial eligibility/categorical relationship for the ADvantage program
Section 11 Determining financial eligibility for ADvantage program services
Section 12 Certification for ADvantage program services
Section 13 Certification for ADvantage program services [REVOKED]
Section 14 Case management services
Section 15 Redetermination of eligibility for ADvantage services
Section 16 Member annual level of care re-evaluation and annual service plan reauthorization
Section 17 Supplemental process for expedited eligibility determination (SPEED)
Section 18 ADvantage services during hospitalization or NF placement
Section 19 Closure or termination of ADvantage services
Section 20 Case transfer between categories [REVOKED]
Section 21 Case changes
Section 21.1 ADvantage and agency Personal Care provider certification
Section 22 Billing procedures for ADvantage services
Section 23 Disclosure of information on health care providers and contractors
Section 24 Referral for social services
Section 25 Address Confidentiality Program
Section 26 Ethics of Care Committee
Section 27 Incident reporting

 

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.