Topic: OHCA
To initiate the filing of a lien, the worker must submit a Medicaid Estate Recovery, form 08MA025E, a copy of the deed and/or a document from the County Assessor’s office, a copy of the signed Acknowledgement of Intent to Return Home form 08MA024E (FSS-ML-1), and form 08MA010E (MA-10) by email to OHCA. Please include POA/Guardianship […]
Effective July 1, 2015, SoonerCare began covering certain incontinence supplies (diapers, pull-ons, wipes, underpads and liners) for children ages 4-20. The only approved source for these supplies is People First Industries (PFI). Please refer to the following FAQS from the Oklahoma Health Care Authority regarding Incontinence Supplies. What kind of incontinence supplies may my child […]
Policy Link Regarding TEFRA
Online Enrollment (OE) – A web-based system developed by the Oklahoma Health Care Authority to determine Medicaid eligibility for certain individuals. Detailed systems information is available under Quest: OHCA Online Enrollment. Policy regarding this term is located at: Public Assistance Procedures (all programs): 340:65-3-1. Determination of eligibility; 340:65-3-6. Cash assistance payment procedures; 340:65-3-8. Continuing eligibility […]
MAGI – acronym for Modified Adjusted Gross Income. Financial eligibility for persons eligible to apply using Online Enrollment (OE) is determined using the modified adjusted gross income on income tax forms. Policy regarding this term is located at: SoonerCare (Medicaid)[OE]: 317:35-5-46. Determination of income and resources for categorical relationship to pregnancy-related services; 317:35-6-1. Scope and […]
Medicaid – is a health insurance program jointly funded by the state and federal governments but managed by the states. This term is used throughout SoonerCare (Medicaid) policy. Chapter 35. Medical Assistance for Adults and Children – Eligibility: 317:35-1-1. Purpose 317:35-1-2. Definition 317:35-1-3. Legal bases Coverage and Exclusions: 317:35-3-1. Payment for Medicaid Eligibility and Countable […]
LOCEU – acronym used for the Oklahoma Health Care Authority’s Level of Care Evaluation Unit.
Coding used to certify a case when there is a guardian or representative on a SSP case: For medical benefits, the name of case should match the child’s name for whom the medical benefits if for. The name of the guardian or representative is put in the “Guardian, Substitute Payee, Conservator, Authorized Representative, Other” block […]
Categorically needy – is a SoonerCare (Medicaid) term that means income and when applicable, resources are within the standards for the category to which the individual is related. Policy regarding this term is located at: SoonerCare (Medicaid)[ABD]: 317:35-1-2. Definitions; 317:35-7-38. Financial eligibility of categorically needy individuals related to ABD; 317:35-7-44. Eligibility for TB related services; […]
Categorical relationship – a term used in the SoonerCare (Medicaid) Program that means the individual meets basic eligibility requirements for an eligibility group. An adult must be pregnant, have children under the age of 18 in the home, be 65 years of age or older, or meet the Social Security Administration’s definition for being disabled […]