OHCA Policies and Rules

Search Entire Policy
OHCA Policies and Rules Main Page

Part       ROOM AND BOARD PROVIDERS

317:30⊂chapter=5∂=31--320.Eligible providers
[Issued 1-05-95]
All providers of accommodations for overnight lodging, which may include meals, for clients to obtain medical services must have entered into a contract to provide services to eligible individuals. Each provider must agree to accept the payment made by this Authority as full and complete reimbursement for such services.

317:30⊂chapter=5∂=31--321.Coverage by category
[Revised 06-25-07]
Payment is made to Room and Board Providers as set forth in this Section.
(1) Adults. Payment is made to Room and Board Providers for room and board of an eligible adult and an escort, if necessary, when authorized by OHCA. Room and Board is authorized by, Room and Board Order form, for Adults and Children. A copy of the authorization must be attached to each claim along with the dates of stay and signature of authorized escort.
(2) Children. Coverage for children is the same as for adults.
(A) Services, deemed medically necessary and allowable under Federal Medicaid regulations, may be covered by the EPSDT/OHCA Child Health program even though the services may not be part of the OHCA SoonerCare program. Such services must be prior authorized.
(B) Federal Medicaid regulations also require the State to make the determination as to whether the service is medically necessary and do not require the provision of any items or services that the State determines are not safe and effective or which are considered experimental.

317:30⊂chapter=5∂=31--322.Procedure codes and allowable amounts [REVOKED]
[Revoked 06-25-07]

317:30⊂chapter=5∂=31--323.Claim Form [REVOKED]
[Revoked 6-27-02]

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.