Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 2 - Grievance Procedures and Process
Subchapter 1 - Administrative Appeals
Section 317:2-1-2.6 - Continuation of benefits or services pending appeal
Current through Vol. 41, No. 13, March 15, 2024
(a) In accordance with Section 431.230 of Title 42 of the Code of Federal Regulations, if an appellant submits a written request for a hearing within sixty (60) days of the notice of the adverse Agency action, the appellant may also request that existing benefits or services (hereinafter, collectively referred to as "services") be continued or reinstated until the earlier of dismissal of the appeal, appellant's withdrawal of the appeal, or an initial hearing decision adverse to the appellant.
(b) If the appellant fails to indicate a preference as to continuation or reinstatement of services in a written request for hearing made within sixty (60) days of the notice of the adverse Agency action, services shall be continued or reinstated. Provided, however, that a SoonerCare member shall not be entitled to continuation or reinstatement of services pending an appeal related to the following:
(c) If services are continued or reinstated during the appeals process and the hearing is not decided in the appellant's favor, OHCA may seek to recover reimbursement of all services received pending the hearing decision.