OHCA Policies and Rules
(a) Application. The county office is responsible for taking a new application for Medicaid if an active case is not already in existence. The worker must determine if the individual would be financially eligible for Medicaid benefits as categorically needy according to DHS Appendix C-1, Schedule VIII. B.
(1) When DHS/DDSD resources are sufficient for initiation of HCBW services, the DDSD case manager notifies the DHS county office of the request by DHS form K-13. The application date is the date Form K-13 is received in the county office.
(2) When a request for HCBW originates in the county office, the DHS social worker refers the applicant to the DHS/DDSD Area Office for completion of DHS form DDS-1, Application for Developmental Disabilities Services.
(3) The DHS/DDSD case manager determines whether or not a categorical relationship decision is necessary.
(b) Existing Medicaid case. A new application is not required on existing cases when referral is from a public ICF/MR or nursing facility for an individual returning to the community. The DDSD case manager verifies receipt of Medicaid benefits and notifies the county social worker of the medical eligibility determination (M-S-52) for HCBW/MR by the use of the DHS form K-13 requesting the computer system be updated with the client's new mailing and finding address and the appropriate waiver code. A case number is assigned if necessary, retaining the application date, certification date and redetermination of eligibility date from the existing case with the institutional case number.
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.