Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 113 - LIVING CHOICE PROGRAM
Section 317:30-5-1201 - Benefits for members with intellectual disabilities
Current through Vol. 42, No. 1, September 16, 2024
(a) Living Choice program participants with intellectual disabilities may receive a range of necessary medical and home and community based services for one year after moving from the institution. The one year period begins the day the member occupies a qualified residence in the community. Once this transition period is complete, the member receives services through the Community waiver.
(b) Services must be billed using the appropriate HCPCS or CPT codes and must be medically necessary.
(c) All services must be necessary for the individual to live in the community, require prior authorization, and must be documented in the individual transition plan. The number of units of services the member is eligible to receive is limited to the amounts approved in the transition plan. The transition plan may be amended as the member's needs change.
(d) Services that may be provided to members with intellectual disabilities are listed in paragraphs (1) through (28) of this subsection:
Added at 26 Ok Reg 258, eff 12-1-08 (emergency); Added at 26 Ok Reg 1069, eff 5-11-09; Amended at 29 Ok Reg 1102, eff 6-25-12
