Library: Policy

317:35-23-3. Participant disenrollment

Revised 9-14-18

(a) A member is disenrolled from the program if he/she:

(1) is admitted to a hospital, nursing facility, ICF/IID, residential care facility or behavioral health facility for more than thirty (30) consecutive days;

(2) is incarcerated;

(3) is determined to no longer meet SoonerCare financial eligibility for home and community based services;

(4) determined by the Social Security Administration or OHCA Level of Care Evaluation Unit to no longer have a disability that qualifies for services under the Living Choice program; or

(5) moves out of state.

(b) Payment cannot be made for an individual who is in imminent danger of harm to self or others.