A. 1. The Oklahoma Health Care Authority shall develop standard contract terms for contracted entities to include, but not be limited to, all requirements stipulated by this act. The Authority shall oversee and monitor performance of contracted entities and shall enforce the terms of capitated contracts as required by paragraph 2 of this subsection.
2. The Authority shall require each contracted entity to meet all contractual and operational requirements as defined in the requests for proposals issued pursuant to Section 3 of this act. Such requirements shall include but not be limited to reimbursement and capitation rates, insurance reserve requirements as specified by the Insurance Department, acceptance of risk as defined by the Authority, operational performance expectations including the assessment of penalties, member marketing guidelines, other applicable state and federal regulatory requirements, and all requirements of this act including, but not limited to, the requirements stipulated in this section.
B. The Authority shall develop methods to ensure program integrity against provider fraud, waste, and abuse.
C. The Authority shall develop processes for providers and Medicaid members to report violations by contracted entities of applicable administrative rules, state laws, or federal laws.
Added by Laws 2022, c. 395, § 8, eff. July 1, 2022.
Structure Oklahoma Statutes
§56-26.6. Eligibility for assistance.
§56-26.7. Temporary relief employment of destitute but able-bodied persons.
§56-26.8. Victims of disasters.
§56-26.9. Equipment of governmental agencies, use of.
§56-26.13. Abolition of Oklahoma Emergency Relief Board.
§56-26.14. Transfer of properties, records and funds to Department of Public Welfare.
§56-26.16. Rules and regulations - Payments.
§56-26.17. Department of Human Services - Classification of employees.
§56-26.18. Application for relief - Allowance of false claims - Penalty.
§56-27.1. Community work and training program.
§56-27.2. Rules and regulations.
§56-27.3. Work assignments - Duration of work - Earnings.
§56-27.4. Suspension or denial of assistance for failure to work or misconduct.
§56-27.5. Approval of projects.
§56-27.6. Furnishing transportation, tools, equipment and supervision.
§56-27.7. Nature of work - Effect on regular workers.
§56-27.8. Effect of work on right to assistance.
§56-27.9. Termination of agreement.
§56-27.10. Department of Public Welfare - Scope of participation.
§56-27.11. Conflicts with federal law.
§56-28.1. Planned parenthood - Educational materials and information.
§56-31. Overseers of the indigent.
§56-32.1. Authority to establish county department.
§56-32.2. Director of Human Services - Social Services.
§56-32.3. Employment of pharmacists and doctors – Compensation – Blanket bond.
§56-33. County to support indigent persons - Power to provide indigent care facility.
§56-34. County may rent indigent care facility.
§56-35. Where county has no indigent care facility.
§56-37. Overseers to receive person removed - Appeal.
§56-38. Time of hearing appeal.
§56-39. Court may amend order of removal.
§56-41. Commissioners to bring suits.
§56-42. Administrator of indigent care facility.
§56-44. Tax levy for indigent care facility.
§56-46. Duties when complaint is made.
§56-47. Overseers to maintain documentation concerning indigent.
§56-48. Poor person may apply to district court.
§56-49. Proceedings when legal residence not known.
§56-52. Compensation of overseers.
§56-53. Submission of accounts and sworn statements of overseers.
§56-54. Sickness or death of poor stranger.
§56-57.1. Intent of Legislature.
§56-59.1. Income tax check-off for indigent health care - Indigent Health Care Revolving Fund.
§56-63. Department of Human Services - Responsibilities and duties.
§56-64. Exemptions from act - Duties of hospitals and clinics - Reports and documentation.
§56-65. Screening of persons requesting assistance.
§56-66. Reimbursements and payments to hospitals and clinics - Disbursement of state monies.
§56-91. Issue of bonds authorized.
§56-92. Election authorized - Manner of calling election.
§56-93. Contents of proclamation.
§56-96. Rate of interest - Payment - Signatures - Recording.
§56-98. Purchase of lands and buildings.
§56-99. Persons admitted - Authority and supervision.
§56-111. Erection of buildings - Care of patients.
§56-112. Supervision of treatment of patients.
§56-114. Employment of nurses, etc.
§56-121. When commissioners may sell.
§56-122. Resolution of county commissioners - Appraisement.
§56-123. Publication of notice.
§56-124. Procedure - Bids - Report to district judge.
§56-125. Deeds - Order for execution - Signing, acknowledging and attesting - Prima facie evidence.
§56-126. Proceeds - Disposition.
§56-143. Conditions of allowance.
§56-144. Termination or modification of allowance.
§56-145. Provisions when fund is insufficient.
§56-146. Class of widows entitled.
§56-147. Unlawful procurement - Penalty for attempt.
§56-148. Judgments for allowance - Citizens may petition rehearing.
§56-162. Duties and powers of the Director.
§56-162.1. Additional names for Department of Public Welfare, Welfare Commission and Director.
§56-162.1a. Additional names for Department of Human Services and Director of Human Services.
§56-162.2. Campus police and juvenile officers - Appointment - Powers.
§56-162.3. Police officers - Certification.
§56-162.4. Peace officers for Commission.
§56-163. County boards - Appointment - Duties.
§56-163.1. Satellite meal sites.
§56-163.2. Josephine Meade Anti-Hunger Act.
§56-163.3. Leftover food – Prevention of waste.
§56-164. Eligibility for assistance.
§56-165. Amount of assistance.
§56-166. Application for assistance.
§56-166.1. Application for assistance resulting from birth of child.
§56-166.2. Concurrent applications by active duty military members.
§56-167. Investigation of applications.
§56-167.1. Request for financial records - Consent.
§56-167.2. Subpoena power of the Inspector General.
§56-168. Appeal by applicant - Procedure - Review.
§56-169. Reinvestigation of assistance grants.
§56-172. Assistance to incompetent to be paid to guardian.
§56-173. Assistance inalienable.
§56-175. Assistance to crippled children.
§56-176. Homeless and neglected children.
§56-176.1. Investigation or study involving custody, placement or adoption of children - Fee.
§56-177. Assent to provisions of federal law.
§56-182. Charging fees for representing applicant prohibited.
§56-183. Confidentiality of applications, information and records – Misuse of information.
§56-185. Fraud in obtaining assistance - Penalties - Signage.
§56-186. Violations of the provisions of this act a misdemeanor.
§56-188. Provisions severable.
§56-191. Contents of affidavit.
§56-192. Exemption from costs in guardianship cases.
§56-193. Release of liens - Filing.
§56-198.9. Increase in assistance payments.
§56-198.10. Increase in assistance payments.
§56-198.11b. Public policy - Strategic Planning Committee on the Olmstead Decision.
§56-198.13. Legislative findings and intent.
§56-198.15. Self-Directed Care Option.
§56-198.16. Implementation - Requirements - Feasibility of expansion - Review.
§56-198.17. Nursing home prescreening process - Rules.
§56-199. Visual or optometric services - Free choice of practitioner and profession.
§56-199.2. Cooperation with commissions and state agencies - Interpreter services.
§56-200.1. Payment of expenses for sterilization of male recipients of public assistance.
§56-201. Group hospitalization insurance.
§56-203. Hospitalization and medical care system in the Department of Public Welfare.
§56-204. Vendor drug program - Exemption of certain drugs.
§56-204.1. Expansion of vendor drug program.
§56-212. Matching contributions.
§56-213. Reservation of employer's share of contributions - Deduction of employees' share.
§56-214. Reports - Duties of Director.
§56-215. State Budget Director OASI fund.
§56-222. Audit of financial records of hospitals as to per diem costs.
§56-223. Human Services Medical and Assistance Fund.
§56-224. Human Services Disbursing Fund.
§56-226. Department of Human Services Federal Disallowance Fund.
§56-228. Guardianship voucher program.
§56-229. OK Benefits Revolving Fund.
§56-230.51. Program components.
§56-230.53. Exclusion of automobile from determination of applicant's resources.
§56-230.54. Individual development accounts.
§56-230.55. Unmarried minor recipients - Adult supervised living arrangements.
§56-230.56. Immunization incentive program.
§56-230.57. Residency requirement.
§56-230.59. Substance abuse study.
§56-230.60. Disclosure of persons responsible for child support as precondition to TANF benefits.
§56-230.61. Extension of transitional Medicaid, child care assistance and support services.
§56-230.62. Contracts for literacy remediation, work activities, training and other services.
§56-230.64. Case management services.
§56-230.65. Employability and literacy assessment - Personal responsibility agreements.
§56-230.66. Compulsory school attendance.
§56-230.67. Application for Earned Income Tax Credit - Assistance from Department of Human Services.
§56-230.69. Child care resource and referral centers.
§56-230.70. One-stop Career/Employment Centers.
§56-230.72. Medicaid assistance.
§56-230.76. TANF Options Task Force — Membership.
§56-230.77. Delivery system for redemption of vouchers for services from faith-based providers.
§56-230.78. Oklahoma Marriage Initiative public service announcement campaign.
§56-231. Applicant for assistance to request filing of criminal charges.
§56-232. Public Welfare Commission - Notice and information to district attorney.
§56-233. Referral of willfully delinquent parents to district attorney for prosecution.
§56-234. Actions to secure compliance with court's support or maintenance orders.
§56-235. Payments to Department of Human Services.
§56-236. Legal division or unit - Contracts for private legal counsel.
§56-237. Support collection, parent location and paternity determination services.
§56-237.5. AFDC payments to adult custodians - Purpose.
§56-237.6. AFDC recipients required to participate in parent or early childhood education programs.
§56-237.8. Order of administrative law judge.
§56-237.9. Administrative law judge authorized to conduct hearings by electronic means.
§56-237.9a. Electronic transmittal of documents, electronic signature - Rules.
§56-237.10. Docketing of administrative orders.
§56-237A. Notice to obligor - Administrative procedures.
§56-238. Payment of public assistance creating debt to Department.
§56-238.2. Assignment of earnings to be honored by employer - Release from liability.
§56-238.3a. Failure to appear at hearing - Administrative order.
§56-238.4. Hearing on debt - Appeal - Orders.
§56-238.5A. Use of child support guidelines.
§56-238.6. Administrative procedures - Use.
§56-238.7. Modification of final order to pay child support.
§56-240.1. Authority of Child Support Enforcement Division to pursue collection of support.
§56-240.2. Initiation of enforcement proceedings by Division.
§56-240.4. Admissibility of report of payments.
§56-240.5. Child support services - Fee.
§56-240.6. Enforcement of child support obligation.
§56-240.7. Release of child support arrearage information to consumer reporting agencies.
§56-240.8. Publication and distribution of child support collection services.
§56-240.9. Filing cases involving concurrent jurisdiction - Enforcement of foreign orders.
§56-240.13. Guidelines for indirect contempt and purge fees - Request to Oklahoma Supreme Court.
§56-240.16. Court-ordered payment plan - Probationary continuation of license.
§56-240.17. Termination of suspension, revocation, nonissuance, or nonrenewal order.
§56-240.19. Implementation of order of suspension, revocation or probation.
§56-240.20. Fees to cover administrative costs.
§56-240.21. Promulgation of rules.
§56-240.22. Financial institution data match reporting system.
§56-240.22A. Financial institution data match reporting system - Definitions.
§56-240.22B. Information required from financial institutions.
§56-240.22G. Financial institution data match reporting system - Levy of match accounts.
§56-240.23. Orders over signature of Director.
§56-240.24. Delinquent or missing parent "Most Wanted" list.
§56-241. Participation in food stamp program - Agreements - Distribution - Reimbursement procedures.
§56-241.1. Electronic benefit identification program - Implementation.
§56-241.3. Limitation of benefits - Amount and receipt of allotments.
§56-241.4. Restrictions on debit and electronic benefit cards - Violations.
§56-242. Distribution of federally donated agricultural commodities - Limitations.
§56-243. Food stamp fraud - Penalties.
§56-244. Conflicting federal statutes.
§56-245. Short title - Creation of committee - Purpose - Membership - Meetings - Expenses.
§56-245.1. Partnerships to generate funding.
§56-246. HOPE Act – Eligibility verification – Independent vendors.
§56-247. Quarterly review of eligibility – Notice of discrepancy or change.
§56-248. Identity authentication for applicants.
§56-249. Sharing of information if fraud suspected.
§56-250. Promulgation of rules and regulations.
§56-253. Legislative findings.
§56-255. Contracts with fiduciary organizations - Evaluation criteria - Responsibilities - Grants.
§56-256. Individual development account (IDA) - Matching funds.
§56-257. Permitted uses of individual development accounts.
§56-258. Withdrawals under false pretenses or for other than approved purposes - Penalties.
§56-259. State agency responsible for implementation of act.
§56-260. Individual Development Account (IDA) Revolving Fund.
§56-300. Oklahoma Medical Center - Institutions included.
§56-327.1. Purchase or lease of passenger motor vehicles.
§56-330. Use of monies - Federal funds - Commission as sole state agency.
§56-335. Outpatient services for former patients of Taft State Hospital.
§56-343. Basic medical services programs at schools for persons with intellectual disabilities.
§56-347. Guardian and conservator services.
§56-411. Deceased child or retarded person - Funeral arrangements and expenses.
§56-530.2. Purpose and policy of act - Maintenance of minimum standards - Certificate required.
§56-530.4. Application for certificate - Provisional certificate.
§56-530.7. Revocation or refusal to renew certificate - Notice and hearing.
§56-530.8. Appeals - Injunctions - Violations.
§56-604. Family Support Program - Eligibility criteria.
§56-605. Rules and regulations.
§56-607. Termination of assistance.
§56-608. Hearing upon denial or termination.
§56-625.1. Short title – Purpose - Definitions.
§56-625.2. Statewide Independent Living Council – Contracts for services.
§56-703. Credit for providing volunteer in-home service.
§56-705. Volunteer Service Credit Bank Program Advisory Council.
§56-1005.1. Definitions – Fraudulent receipt of assistance.
§56-1005.2. Short title - Defunding Fetal-Body-Parts Trafficking Act.
§56-1005.4. Violations – Penalties – Investigation.
§56-1006. Medicaid fraud - Penalties.
§56-1007. Additional penalties.
§56-1007.1. Short title - Defunding Statutory Rape Cover-up Act.
§56-1007.3. Eligibility for Medicaid reimbursement – Failure to report statutory rape.
§56-1007.4. Promulgation of rules to investigate complaints.
§56-1008. Annual report on Medicaid fraud.
§56-1009.1. Short title - Legislative findings.
§56-1010.8A. Medicaid Health Improvement Revolving Fund.
§56-1010.13. Representatives of incompetent Medicaid beneficiaries.
§56-1010.21. Short title – Purpose - Definition.
§56-1010.22. Establishment of program – Services to be offered – Target population.
§56-1011.3. Powers, duties and responsibilities of Health Care Authority – Program opt-out option.
§56-1011.5. Nursing facility incentive reimbursement rate plan.
§56-1011.6. Disease management program.
§56-1011.7. Plan to implement alternatives for long-term care.
§56-1011.8. Program to encourage use of primary care services in lieu of emergency room services.
§56-1011.9. Establishment of method to reduce payment error rate - Reporting of errors.
§56-1011.10. Health care benefit waiver for full-time state university or college students.
§56-1011.11. Durable medical equipment retrieval program – Rules - Definition.
§56-1011.13. Nursing Facility Supplemental Payment Program Revolving Fund.
§56-1011.14. Penalties and interest for failing to timely pay.
§56-1011.15. SoonerCare eligibility modifications.
§56-1012.1. Short title - Commitment to Care for People with Complex Physical Disabilities Act.
§56-1012.3. Coverage for specialty provider services.
§56-1012.4. Regulations and policies for CRT products and services.
§56-1015.3. Requirements for Medicaid claims on wheeled mobility purchases.
§56-1016. Study of coverage for prosthetic and orthotic devices for Medicaid-eligible individuals.
§56-1017.1. Oklahoma Choices for Long-Term Care Act - Purpose.
§56-1017.2. Legislative findings.
§56-1017.4. Enrollment system.
§56-1017.5. Request for Proposal.
§56-1017.6. Options counseling for long-term care for persons 55 or older.
§56-1018. Reductions in planned services – Prospective application only.
§56-1020. Community-based program of services - Administration - Gifts.
§56-1025.3. Community services worker registry.
§56-1025.4. Violations and penalties.
§56-1030.3. Compensation of receiver.
§56-2002. Nursing Facilities Quality of Care Fee.
§56-2004. Home-Based Support Quality Assurance Assessment.
§56-3001. Short title - Purpose - Joint implementation by state agencies.
§56-3002. Designation of participating agencies - Respective responsibilities - Report.
§56-3002.1. Aging and Disability Resource Consortium initiative.
§56-3002.2. Short title - Oklahoma Caregiver Support Act.
§56-3002.3. Expansion of service locations.
§56-3002.4. Support for awareness of information, services and training.
§56-3002.5. Oklahoma Options Counseling for Long-term Care Program Act.
§56-3002.6. Legislative findings.
§56-3002.7. Definitions - Options Counseling for Long-term Care Program - Consultation.
§56-3003. Contents of coordinated system - Implementation deadlines.
§56-3021. Oklahoma 2-1-1 Collaborative - Duties and responsibilities.
§56-3051. Discontinuance of state-administered resource centers.
§56-3100. Aging Services Division - Duties.
§56-3121. Compassionate Care Task Force.
§56-4000. Oklahoma College Savings Plan exemption.
§56-4001.2. Options for a qualified ABLE program.
§56-4001.3. Use of financial institutions as depositories and managers.
§56-4001.4. Establishment of accounts – Contributions - Withdrawals.
§56-4002.1. Short title - Ensuring Access to Medicaid Act.
§56-4002.1a. Legislative intent.
§56-4002.3a. Capitated contracts with contracted entities for delivery of Medicaid services.
§56-4002.3b. Capitated contracts – Requests for proposals – Competitive bids.
§56-4002.3c. Process for assignment of Medicaid members to contracted entities.
§56-4002.3d. Selection of primary care provider by members.
§56-4002.4. Network adequacy standards for contracted entities.
§56-4002.4a. Standard contract terms.
§56-4002.6. Requirements for prior authorizations.
§56-4002.7. Requirements for processing and adjudicating claims.
§56-4002.8. Uniform procedures for review and appeal for adverse determinations.
§56-4002.10. Readiness review.
§56-4002.11. Scorecard comparing contracted entities and dental benefit managers.
§56-4002.12. Minimum rates of reimbursement – Value-based payment arrangements.
§56-4002.12a. Dental benefit managers to maintain Medicaid Dental Advisory Committees.
§56-4002.12b. Oklahoma Health Care Authority to ensure sustainability.
§56-4002.13. Medicaid Delivery System Quality Advisory Committee.
§56-4002.14. Uniform defined measures and goals - Provider quality metrics.