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Part 9      CERTIFICATION, REDETERMINATION AND NOTIFICATION

317:35-9-75.Certification for long-term medical care through ICF/IID, HCBW/IID services and to persons age 65 and older in a mental health hospital

[Revised 11-01-17]                                     

(a) Application date.  If the applicant is found eligible for SoonerCare, certification may be made retroactive for any service provided on or after the first day of the third month prior to the month of application and for future months. The first month of the certification period must be the first month that medical service was provided and the recipient was determined eligible.

(b) Certification period for long-term medical care.  A certification period of twelve (12) months is assigned for an individual who is approved for long-term care.

 

317:35-9-76.Redetermination of financial eligibility for long-term medical care
[Revised 6-25-04]
A redetermination of financial eligibility must be completed prior to the end of the certification period. A notice is generated only if there is a change which affects the client's financial responsibility.

317:35-9-77.Case transfer between categories
[Revised 6-26-00]
If it becomes necessary to transfer a Medicaid long-term care case from one category to another because of change of age, income, or marital status, a new application is not required. If someone other than the client or guardian signed the original application form and the transfer is to a money payment case, an application with the client's signature is required. The new case is certified retaining the original certification date and redetermination date, using the appropriate code for transfer from the old category and the appropriate effective date which coincides with the closure of the previous case category. Recipients and appropriate medical providers are notified of the new case number and category by computer generated notice.

317:35-9-78.Case changes
[Revised 6-30-96]
Any time there are changes which affect the long-term care case, computer generated notices are issued, if appropriate, based on the action taken.

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.