Library: Policy

317:30-1-2. Authority responsibility; fiscal agent

Issued 7-27-95

(a) As the single State Agency, the Oklahoma Health Care Authority (OHCA) administers the medical programs which make available appropriate medical services to eligible individuals through the Title XIX Medicaid Program.  OHCA is directly responsible for administration of the medical programs including development of policy, establishment of payment rates, certain provider hearings, and provider relations.

(b) The Authority contracts with a fiscal agent for operation of the medical claims processing system.  The Fiscal Agent is responsible for processing all medical claims for individuals eligible under the Authority's medical programs and will make payment for services based on established policy and procedures.