Library: Policy

317:30-5-327. Eligibility for SoonerRide NET

Revised 9-1-15

     Transportation is provided when medically necessary in connection with examination and treatment to the nearest appropriate facility in accordance with 42 CFR 440.170. As the Medicaid Agency, the Oklahoma Health Care Authority (OHCA) is the payer of last resort, with few exceptions.  When other resources are available, those resources must first be utilized. Exceptions to this policy are those receiving medical treatment through Indian Health Services and those eligible for the Crime Victims Compensation Act. Individuals considered fully dual eligible qualify for SoonerRide. However, SoonerRide excludes those individuals who are categorized as:

• (1) Qualified Medicare Beneficiaries(QMB);

• (2) Specified Low Income Medicare Beneficiaries (SLMB) only;

• (3) Qualifying Individuals-1 and individuals who are in an institution for mental disease (IMD);

• (4) inpatient;

• (5) institutionalized;

• (6) Home and Community Based Waiver members, with the exception of the In-home Supports Waiver for Children, the Advantage Waiver, the Living Choice demonstration, and the Medically Fragile Waiver.