How to Deny LTC Medical and Section K LTC Authorizations

Instructions regarding proper denials for LTC

PACE Procedures – Certifying PACE with Vending Medical

Procedure for Certifying PACE with Vending Medical

Harmony Procedures – Financial Eligibility

ELDERS Procedures regarding Financial Eligibility

Harmony Procedures – Closures/Denials

ELDERS Procedures concerning Closures and Denials

UpdatedLife-Threatening Crisis FAQs

Frequently Asked Questions Regarding LIHEAP/ECAP.

Updated$20 General Income Exclusion

327:35-5-42(d)(1)and(5)(B) The General Income Exclusion (GIE) is a $20 per month income deduction. It is mostly used to bring down countable income that is barely over the standard, so the client can be eligible for a particular benefit. For QMB, SLMB and QI-1, the GIE can be used: First on unearned income If any of […]

Tuberculosis (TB) Cases

317:35-5-4.(4) 317:35-5-47 317:35-7-60(a)(5) 317:35-7-44   The TB program is intended to cover treatment for the condition. It does not provide full SoonerCare coverage. If applicant wants full SoonerCare but is not age 65 or older, s/he will need to apply with Social Security to get a disability decision. What is needed to determine eligibility Verification […]

Pregnancy and Disability-Related Medical

Process regarding Disability-Related Medical and Pregnancy

UpdatedAged, Blind, Disabled (ABD)

Policy Links Regarding ABD

UpdatedProcess for Closing Medical (Death)

Process for closing medical on reason of death.